MEDICARE: HOMEWATCH CAREGIVERS OF ROCK HILL

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	385H00000X	Respite Care
2	385HR2055X	Child Mental Illness Respite Care
3	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
4	385HR2065X	Child Physical Disabilities Respite Care
5	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1467925255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMEWATCH CAREGIVERS OF ROCK HILL

Provider Business Mailing Address
First Line	:	PO BOX 37076
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-0517
Country	:	US
Telephone Number	:	803-752-4724
Fax Number	:	803-752-4724

Provider Business Practice Location Address
First Line	:	2342 EBENEZER RD STE A
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-8256
Country	:	US
Telephone Number	:	803-752-4724
Fax Number	:	803-752-4724

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHAWN SMITH
Credential	:
Telephone Number	:	803-752-4724

Provider Enumeration Date	:	01/04/2019
Last Update Date	:	01/04/2019

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