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General NPI Number Information
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NPI Number | 1982115291
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Entity Type | Organization
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Legal Business Name | THE SHEPHERD'S HOUSE OF TENDER CARE
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Dates
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Enumeration Date | 10/13/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 103 HOLLY ST E
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City | HAMPTON
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State | SC
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Zip | 29924-3913
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Country | US
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Telephone | 803-398-7982
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 14
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City | HAMPTON
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State | SC
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Zip | 29924-0014
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Country | US
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Telephone | 803-398-7982
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOYCE DAVIS
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Credential | LPN
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Telephone | 803-398-7982
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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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