MEDICARE: CHERISH IN-HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1093429136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHERISH IN-HOME CARE LLC

Provider Business Mailing Address
First Line	:	3658 S IRBY ST STE A
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29505-5225
Country	:	US
Telephone Number	:	843-407-5415
Fax Number	:	843-702-0086

Provider Business Practice Location Address
First Line	:	3658 S IRBY ST STE A
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29505-5225
Country	:	US
Telephone Number	:	843-407-5415
Fax Number	:	843-702-0086

Authorized Official
Title or Position	:	OWNER
Name	:	NYASIA I'KEIA CUMMINGS
Credential	:
Telephone Number	:	843-407-5415

Provider Enumeration Date	:	01/12/2023
Last Update Date	:	05/12/2023

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