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General NPI Number Information
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NPI Number | 1194374389
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Entity Type | Organization
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Legal Business Name | VICTRESS HEALTHCARE STAFFING SOLUTIONS
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Dates
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Enumeration Date | 09/10/2019
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | 6646 KATO BAY RD
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City | RIDGELAND
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State | SC
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Zip | 29936-7879
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Country | US
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Telephone | 843-592-5088
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Fax | 843-781-8890
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Provider Business Mailing Address
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Address Line | PO BOX 1094
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City | RIDGELAND
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State | SC
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Zip | 29936-2618
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Country | US
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Telephone | 843-592-5088
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Fax | 843-781-8890
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Authorized Official
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Title or Position | OWNER
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Name | MS. LADAWN MACK
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Credential | RN
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Telephone | 843-592-5088
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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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