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Organization
KLASSIC BLACK ENTERPRISE LLC
Active
Organization
KLASSIC BLACK ENTERPRISE LLC
Active
Other names
P23 Care
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA CLONMELL (OWNER)
(803) 464-3424
Entity
Organization
Contact information
Practice address
698 BULTMAN DR UNIT L, SUMTER, SC 29150-2549
(803) 464-3424
Mailing address
937 MORDRED ST, SUMTER, SC 29154-7407
(803) 464-3424
(803) 464-3424
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
03/24/2025
Last updated
06/20/2025
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