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Organization
MARTHA AND JOSIE JENKINS JR. LLC DOB ECSDC
Active
Organization
MARTHA AND JOSIE JENKINS JR. LLC DOB ECSDC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARTHA E. JENKINS LPN (OWNER/ ADMINISTRATOR)
(843) 216-1070
Entity
Organization
Contact information
Practice address
999 LAKE HUNTER CIR STE C, MOUNT PLEASANT, SC 29464-5427
(843) 216-1070
(843) 216-2470
Mailing address
999 LAKE HUNTER CIR STE C, MOUNT PLEASANT, SC 29464-5427
(843) 216-1070
(843) 216-2470
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
15331
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
C94777C
—
SC
05
—
EN0867
—
SC
05
—
X6987
—
SC
Enumeration date
01/07/2008
Last updated
01/07/2008
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