# MARLBORO PRESTIGE HOME CARE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871161042
- **Authorized official:** SHAVON STANTON (OWNER/MEMBER)
- **Authorized official phone:** (843) 535-9611

## Contact information

- **Practice address:** 603 BROAD ST STE F, BENNETTSVILLE, SC 29512-4072
- **Practice address phone:** (843) 535-9611
- **Mailing address:** 603 BROAD ST STE F, BENNETTSVILLE, SC 29512-4072
- **Mailing address phone:** (843) 535-9611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |

## Other

- **Enumeration date:** 06/15/2021
- **Last updated:** 06/15/2021