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General NPI Number Information
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NPI Number | 1063937480
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Entity Type | Organization
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Legal Business Name | HARLEY HOME CARE
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Dates
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Enumeration Date | 08/07/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 136 ALOHA DR
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City | NICHOLS
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State | SC
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Zip | 29581-7028
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Country | US
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Telephone | 843-526-2651
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Fax |
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Provider Business Mailing Address
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Address Line | 136 ALOHA DR
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City | NICHOLS
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State | SC
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Zip | 29581-7028
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Country | US
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Telephone | 843-526-2651
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. SHIRLEE MARIA TAYLOR-HARLEY
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Credential |
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Telephone | 843-526-2651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | IHCP-0630
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License Number State | SC
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