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General NPI Number Information
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NPI Number | 1093219123
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Entity Type | Organization
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Legal Business Name | COMPLETE CARE MANAGEMENT SERVICES
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Dates
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Enumeration Date | 03/22/2018
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Last Update Date | 11/01/2021
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Provider Practice Location Address
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Address Line | 716 UNION ST
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City | SPARTANBURG
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State | SC
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Zip | 29306-3629
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Country | US
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Telephone | 864-517-0350
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Fax |
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Provider Business Mailing Address
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Address Line | 716 UNION ST
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City | SPARTANBURG
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State | SC
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Zip | 29306-3629
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Country | US
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Telephone | 864-517-0350
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. SATREVA DENEE DOGAN
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Credential | RN
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Telephone | 864-517-0350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | IHCP-0724
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License Number State | SC
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