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General NPI Number Information
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NPI Number | 1679936520
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Entity Type | Organization
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Legal Business Name | COMPLETE CARE LLC
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Dates
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Enumeration Date | 03/29/2016
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Last Update Date | 03/29/2016
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Provider Practice Location Address
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Address Line | 204 SUMMER VIEW RD
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City | SUMMERVILLE
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State | SC
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Zip | 29486-8369
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Country | US
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Telephone | 631-921-5886
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Fax | 843-872-0527
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Provider Business Mailing Address
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Address Line | 204 SUMMER VIEW RD
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City | SUMMERVILLE
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State | SC
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Zip | 29486-8369
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Country | US
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Telephone | 631-921-5886
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Fax | 843-872-0527
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Authorized Official
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Title or Position | OWNER
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Name | LAURA JEAN BAILEY
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Credential |
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Telephone | 631-921-5886
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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 | 32189
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License Number State | SC
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