Organization
MY NANA'S HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZELMA IZLAR (HEALTH CARE PROFESSIONAL)
(868) 642-0709
Entity
Organization
Contact information
Practice address
201 WEST LN APT 606, CLEMSON, SC 29631-1298
(864) 207-0952
Mailing address
201 WEST LN APT 606, CLEMSON, SC 29631-1298
(864) 207-0952
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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