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General NPI Number Information
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NPI Number | 1881571495
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Entity Type | Organization
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Legal Business Name | BLESSED HAVEN HOMECARE LLC
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 356B EDGEFIELD RD
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-2409
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Country | US
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Telephone | 803-257-5634
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Fax |
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Provider Business Mailing Address
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Address Line | 338 SUDLOW LAKE RD
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City | GRANITEVILLE
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State | SC
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Zip | 29829-3702
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Country | US
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Telephone | 803-257-5634
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHANTE DIGGS
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Credential | RN
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Telephone | 803-257-5634
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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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