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General NPI Number Information
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NPI Number | 1578166088
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Entity Type | Organization
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Legal Business Name | PROVIDING PROMISES LLC
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 3905 W BELTLINE BLVD
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City | COLUMBIA
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State | SC
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Zip | 29204-1503
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Country | US
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Telephone | 803-988-1069
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Fax |
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Provider Business Mailing Address
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Address Line | 104 WHARTON LN
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City | COLUMBIA
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State | SC
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Zip | 29229-7365
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Country | US
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Telephone | 803-465-0866
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KAREN GREEN
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Credential |
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Telephone | 803-465-0688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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