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General NPI Number Information
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NPI Number | 1104275890
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Entity Type | Organization
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Legal Business Name | HEARTFELT HOME CARE, LLC
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Dates
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Enumeration Date | 06/03/2016
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Last Update Date | 03/15/2017
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Provider Practice Location Address
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Address Line | 6236 SAINT ANDREWS RD SUITE 2
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City | COLUMBIA
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State | SC
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Zip | 29212-3148
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Country | US
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Telephone | 803-331-3391
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Fax | 803-470-3646
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Provider Business Mailing Address
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Address Line | 6236 SAINT ANDREWS RD SUITE 2
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City | COLUMBIA
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State | SC
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Zip | 29212-3148
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Country | US
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Telephone | 803-331-3391
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Fax | 803-470-3646
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ETTA SMITH
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Credential |
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Telephone | 803-331-3391
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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-0560
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License Number State | SC
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