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General NPI Number Information
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NPI Number | 1891374112
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Entity Type | Organization
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Legal Business Name | AUTHENTIC PEARLS LLC
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 07/05/2021
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Provider Practice Location Address
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Address Line | 102 METRO DR STE 15
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City | SPARTANBURG
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State | SC
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Zip | 29303-2754
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Country | US
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Telephone | 864-310-4681
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Fax | 864-754-4145
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Provider Business Mailing Address
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Address Line | PO BOX 1194
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City | TAYLORS
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State | SC
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Zip | 29687-0025
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Country | US
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Telephone | 832-276-6702
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ALLENE PEARSON
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Credential |
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Telephone | 864-310-4681
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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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