Organization
PENCHANT COMPANION CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MONIQUE KINARD (OWNER)
(864) 599-9468
Entity
Organization
Contact information
Practice address
2639 BOILING SPRINGS RD, BOILING SPRINGS, SC 29316-6011
(864) 599-9468
(864) 599-9676
Mailing address
2639 BOILING SPRINGS RD, BOILING SPRINGS, SC 29316-6011
(864) 599-9468
(864) 599-9676
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EX0812
MEDICAID CLTC
SC
Enumeration date
01/02/2009
Last updated
06/29/2009
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