Organization
AT HOME SENIOR CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUBIE WILLIAMS RN (RN SUPERVISOR)
(803) 801-0611
Entity
Organization
Contact information
Practice address
1700 MAIN ST, NEWBERRY, SC 29108-3548
(803) 801-0611
(803) 753-9391
Mailing address
1700 MAIN ST, NEWBERRY, SC 29108-3548
(803) 801-0611
(803) 753-9391
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
92255
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EX1053
—
SC
Enumeration date
04/09/2015
Last updated
04/09/2015
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