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General NPI Number Information
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NPI Number | 1942952932
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Entity Type | Organization
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Legal Business Name | KIDSCARE HOME HEALTH OF SOUTH CAROLINA, LLC
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Dates
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Enumeration Date | 01/21/2022
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 4105 FABER PLACE DR STE 420
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City | NORTH CHARLESTON
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State | SC
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Zip | 29405-8594
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Country | US
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Telephone | 843-894-7347
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Fax | 843-278-8599
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Provider Business Mailing Address
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Address Line | 4201 SPRING VALLEY RD STE 600
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City | DALLAS
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State | TX
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Zip | 75244-3631
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Country | US
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Telephone | 866-919-3240
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Fax | 877-300-7394
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Authorized Official
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Title or Position | DIRECTOR OF COMPLIANCE
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Name | KELLY KASKAVAGE
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Credential |
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Telephone | 214-575-2999
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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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