Organization
MY MOTHERS KEEPER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELYN MARIE JACKSON (CERTIFIED NURSES ASSISTANT)
(843) 870-1839
Entity
Organization
Contact information
Practice address
1265 HAMLIN RD, MT PLEASANT, SC 29464
(843) 870-1839
Mailing address
PO BOX 2522, MT PLEASANT, SC 29465
(843) 870-1839
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
120514E
SC
376J00000X
Homemaker
120514E
SC
376K00000X
Nurse's Aide
120514E
SC
Other
Enumeration date
02/27/2008
Last updated
02/27/2008
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