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General NPI Number Information
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NPI Number | 1619731643
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Entity Type | Organization
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Legal Business Name | TRUSTED ALLY HOME CARE - SOUTH CAROLINA LLC
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Dates
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Enumeration Date | 02/09/2024
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 900 TRAIL RIDGE RD # 122
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City | AIKEN
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State | SC
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Zip | 29803-7765
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Country | US
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Telephone | 803-989-5539
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Fax |
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Provider Business Mailing Address
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Address Line | 5299 DTC BLVD # 101
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-3321
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Country | US
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Telephone | 720-601-1712
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. MARK ERICK HENDRICK JR.
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Credential |
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Telephone | 720-601-1712
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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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