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General NPI Number Information
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NPI Number | 1720895733
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Entity Type | Organization
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Legal Business Name | IDA MAE HOMECARE SERVICES LLP
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 12/14/2024
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Provider Practice Location Address
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Address Line | 5 CALENDAR CT
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City | COLUMBIA
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State | SC
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Zip | 29206-4714
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Country | US
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Telephone | 803-728-0144
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Fax |
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Provider Business Mailing Address
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Address Line | 5 CALENDAR CT STE 201F
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City | COLUMBIA
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State | SC
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Zip | 29206-4714
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Country | US
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Telephone | 803-728-0144
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. AVIS N BRICE
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Credential |
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Telephone | 803-429-1788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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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 | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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