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General NPI Number Information
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NPI Number | 1811405947
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Entity Type | Organization
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Legal Business Name | ANNI B'S IN-HOME CARE, LLC
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 01/10/2018
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Provider Practice Location Address
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Address Line | 440 DAVENPORT RD
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City | MULLINS
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State | SC
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Zip | 29574-7368
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Country | US
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Telephone | 516-456-5445
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Fax |
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Provider Business Mailing Address
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Address Line | 727 DEAN DR
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-1107
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LYNWANA JOHNSON
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Credential |
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Telephone | 516-456-5445
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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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