Organization
UPSTATE KINGS & QUEENS IN-HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOLORES ANN LEWIS (CEO)
(864) 382-0247
Entity
Organization
Contact information
Practice address
311 W GEORGIA RD # 1, SIMPSONVILLE, SC 29681-2401
(864) 228-7902
(864) 228-7902
Mailing address
311 W GEORGIA RD # 1, SIMPSONVILLE, SC 29681-2401
(864) 228-7902
(864) 228-7902
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
—
—
253Z00000X
In Home Supportive Care Agency
—
—
347C00000X
Private Vehicle
—
—
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
01/24/2024
Last updated
02/20/2024
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