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General NPI Number Information
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NPI Number | 1215332614
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Entity Type | Organization
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Legal Business Name | PATTERSON HOME SERVICES
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 10/28/2014
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Provider Practice Location Address
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Address Line | 9012 MAPLE GROVE DR 1A
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City | SUMMERVILLE
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State | SC
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Zip | 29485-8865
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Country | US
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Telephone | 843-620-1429
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Fax |
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Provider Business Mailing Address
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Address Line | 9012 MAPLE GROVE DR 1A
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City | SUMMERVILLE
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State | SC
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Zip | 29485-8865
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Country | US
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Telephone | 843-620-1429
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | REGINA PATTERSON
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Credential |
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Telephone | 843-620-1429
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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 | 222017
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License Number State | SC
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