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General NPI Number Information
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NPI Number | 1154623767
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Entity Type | Organization
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Legal Business Name | LITCHFIELD REITREMENT, LLC
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Dates
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Enumeration Date | 12/02/2010
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Last Update Date | 12/02/2010
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Provider Practice Location Address
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Address Line | 120 LAKES AT LITCHFIELD DR
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City | PAWLEYS ISLAND
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State | SC
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Zip | 29585-5502
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Country | US
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Telephone | 843-235-2422
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Fax |
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Provider Business Mailing Address
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Address Line | 120 LAKES AT LITCHFIELD DR
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City | PAWLEYS ISLAND
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State | SC
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Zip | 29585-5502
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Country | US
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Telephone | 843-235-2422
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Fax |
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Authorized Official
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Title or Position | HOME HEALTH ADMINISTRATOR
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Name | DARIA JEFFERS
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Credential | RN
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Telephone | 843-235-2422
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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 | HHA-0204
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License Number State | SC
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