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General NPI Number Information
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NPI Number | 1881148237
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Entity Type | Organization
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Legal Business Name | CHAVIS'S HOME CARE, LLC
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Dates
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Enumeration Date | 08/14/2016
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Last Update Date | 08/15/2016
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Provider Practice Location Address
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Address Line | 300 W CALHOUN ST UNIT C
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City | DILLON
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State | SC
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Zip | 29536-3907
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Country | US
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Telephone | 910-674-0105
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W CALHOUN ST UNIT C
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City | DILLON
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State | SC
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Zip | 29536-3907
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Country | US
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Telephone | 910-674-0105
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Fax | 843-841-4806
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Authorized Official
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Title or Position | CEO
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Name | MR. RYAN BLAKE CHAVIS
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Credential |
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Telephone | 910-674-0105
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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 | IHCP0585
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License Number State | SC
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