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General NPI Number Information
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NPI Number | 1831796515
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Entity Type | Organization
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Legal Business Name | KENDRICK ELEVATION AND ESTEEM PROJECT
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 7719 SAINT ANDREWS ROAD SUITE C
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City | IRMO
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State | SC
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Zip | 29063-2906
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Country | US
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Telephone | 803-708-8415
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Fax |
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Provider Business Mailing Address
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Address Line | 106 ROWE CIR
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City | COLUMBIA
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State | SC
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Zip | 29212-2511
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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/ADMINISTRATOR
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Name | JANICE KENDRICK
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Credential |
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Telephone | 803-609-9002
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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