Organization
GOD IN ME HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PORTIA MACK (DIRECTOR)
(803) 369-9848
Entity
Organization
Contact information
Practice address
807 PINE SPRINGS RD, COLUMBIA, SC 29210-6333
(803) 369-9848
Mailing address
807 PINE SPRINGS RD, COLUMBIA, SC 29210-6333
(803) 369-9848
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
251T00000X
PACE Provider Organization
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
385H00000X
Respite Care
Primary
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
02/17/2021
Last updated
02/17/2021
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