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General NPI Number Information
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NPI Number | 1154080794
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Entity Type | Organization
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Legal Business Name | NIKKICARINGHANDSLLC
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Dates
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Enumeration Date | 12/10/2021
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Last Update Date | 12/10/2021
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Provider Practice Location Address
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Address Line | 204 A MONTAGUE
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City | GREENWOOD
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State | SC
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Zip | 29649-1937
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Country | US
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Telephone | 864-495-4104
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 PHOENIX ST APT 6C
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City | GREENWOOD
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State | SC
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Zip | 29646-4113
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Country | US
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Telephone | 864-495-4104
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DINEKA MARCHELL GILLIAM
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Credential |
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Telephone | 864-495-4104
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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 |
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License Number State |
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