=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598003766
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ZION HOUSE ASSISTANCE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/23/2013
-----------------------------------------------------
Last Update Date | 01/23/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 121 MOORE ST
-----------------------------------------------------
City | WALTERBORO
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29488-4463
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-782-3238
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 121 MOORE ST
-----------------------------------------------------
City | WALTERBORO
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29488-4463
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-782-3238
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. BARBARA ANN WILLIAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 48437823238
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------