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General NPI Number Information
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NPI Number | 1336573526
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Entity Type | Organization
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Legal Business Name | DEVOTED CARE, LLC
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Dates
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Enumeration Date | 08/25/2013
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 7340 PARKLANE RD STE 203
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City | COLUMBIA
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State | SC
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Zip | 29223-7644
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Country | US
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Telephone | 803-763-1163
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Fax | 803-764-1164
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Provider Business Mailing Address
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Address Line | 7340 PARKLANE RD STE 203
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City | COLUMBIA
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State | SC
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Zip | 29223-7644
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Country | US
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Telephone | 803-764-1163
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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 | MRS. KIMBALE LANETTE MACK
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Credential |
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Telephone | 803-479-6297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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