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General NPI Number Information
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NPI Number | 1326728577
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Entity Type | Organization
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Legal Business Name | MY FATHERS TOUCH IN HOME CARE LLC
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Dates
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Enumeration Date | 07/21/2023
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 1253 DICKSON AVE STE 109
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City | HANAHAN
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State | SC
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Zip | 29410-2853
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Country | US
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Telephone | 843-779-4037
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Fax | 843-608-7371
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Provider Business Mailing Address
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Address Line | PO BOX 40331
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City | NORTH CHARLESTON
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State | SC
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Zip | 29423-0331
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Country | US
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Telephone | 843-530-2411
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MAVIS MANIGAULT
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Credential |
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Telephone | 843-530-2411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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