Healthcare Provider Details

I. General information

NPI: 1770353104
Provider Name (Legal Business Name): ABSOLUTE COMPANION HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2024
Last Update Date: 01/07/2024
Certification Date: 01/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 SUNSET BLVD # 10C
WEST COLUMBIA SC
29169-5955
US

IV. Provider business mailing address

1905 SUNSET BLVD # 10C
WEST COLUMBIA SC
29169-5955
US

V. Phone/Fax

Practice location:
  • Phone: 803-722-4171
  • Fax:
Mailing address:
  • Phone: 803-722-4171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: TAMMY M RICHARDSON
Title or Position: OWNER
Credential:
Phone: 803-722-4171