=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760330807
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | T&D HOME CARE SERVICE,LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2026
-----------------------------------------------------
Last Update Date | 03/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 413 SPRINGWATER LOOP
-----------------------------------------------------
City | MYRTLE BEACH
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29588-2930
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 980-355-1700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 413 SPRINGWATER LOOP
-----------------------------------------------------
City | MYRTLE BEACH
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29588-2930
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 980-355-1700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER / ADMINISTRATOR
-----------------------------------------------------
Name | ENKELEJDA AJDARI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 980-355-1700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 385H00000X
-----------------------------------------------------
Taxonomy Name | Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------