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General NPI Number Information
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NPI Number | 1407389620
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Entity Type | Organization
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Legal Business Name | UPSTATE ANGELS, INC
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Dates
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Enumeration Date | 04/05/2017
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 609 E MAIN ST
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City | DUNCAN
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State | SC
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Zip | 29334-9132
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Country | US
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Telephone | 864-881-0520
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Fax |
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Provider Business Mailing Address
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Address Line | 609 E MAIN ST
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City | DUNCAN
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State | SC
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Zip | 29334-9132
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Country | US
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Telephone | 864-881-0520
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JEANETTE MAXEY
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Credential | MSW, LISW-CP
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Telephone | 864-881-0520
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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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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | IHCP-0658
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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