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General NPI Number Information
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NPI Number | 1205344918
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Entity Type | Organization
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Legal Business Name | RISING ANGELS
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Dates
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Enumeration Date | 01/16/2018
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Last Update Date | 01/16/2018
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Provider Practice Location Address
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Address Line | 125 LIONS CLUB RD APT 213
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City | GREENVILLE
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State | SC
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Zip | 29617-2137
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Country | US
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Telephone | 864-436-3256
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Fax |
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Provider Business Mailing Address
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Address Line | 125 LIONS CLUB RD APT 213
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City | GREENVILLE
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State | SC
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Zip | 29617-2137
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Country | US
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Telephone | 864-436-3256
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHERRELLE L FERGUSON
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Credential |
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Telephone | 864-436-3256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | SC
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