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General NPI Number Information
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NPI Number | 1699368357
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Entity Type | Organization
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Legal Business Name | AVODAH HOME CARE LLC
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Dates
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Enumeration Date | 02/13/2021
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 9320 TWO NOTCH RD STE D
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City | COLUMBIA
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State | SC
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Zip | 29223-6402
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Country | US
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Telephone | 803-764-4048
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Fax | 803-781-3292
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Provider Business Mailing Address
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Address Line | 9320 TWO NOTCH RD STE D
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City | COLUMBIA
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State | SC
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Zip | 29223-6402
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Country | US
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Telephone | 803-955-1171
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Fax | 803-781-3292
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. KATRECIA BELGRAVE
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Credential |
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Telephone | 803-240-6264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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