Healthcare Provider Details

I. General information

NPI: 1942877311
Provider Name (Legal Business Name): HEARTS OF HOPE COMFORT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2021
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3575 RUTHERFORD ROAD EXT STE A
TAYLORS SC
29687-2168
US

IV. Provider business mailing address

3575 RUTHERFORD ROAD EXT STE A
TAYLORS SC
29687-2168
US

V. Phone/Fax

Practice location:
  • Phone: 864-346-6669
  • Fax:
Mailing address:
  • Phone: 864-346-6669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: CICELY SIOBON SULLIVAN
Title or Position: ADMINISTRATOR/OWNER
Credential: LPN
Phone: 864-243-8235