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General NPI Number Information
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NPI Number | 1639548266
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Entity Type | Organization
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Legal Business Name | NEW HOME CARE, LLC
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Dates
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Enumeration Date | 09/24/2015
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 104 MANN RD
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City | COLUMBIA
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State | SC
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Zip | 29223-8017
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Country | US
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Telephone | 803-318-7737
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Fax | 803-736-1652
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Provider Business Mailing Address
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Address Line | 104 MANN RD
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City | COLUMBIA
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State | SC
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Zip | 29223-8017
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Country | US
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Telephone | 803-318-7737
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Fax | 803-736-1652
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. JENNIFER CLARICE WHITAKER HOLLEY
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Credential | M.D
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Telephone | 803-318-7737
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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 | 4189441040
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License Number State | SC
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