Organization
CAROLINA COUNTRY CARE IN-HOME LLC
Active
Other names
Cindy L. Jackson
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY L JACKSON DSD, INP (ADMINISTRATOR)
(912) 682-7892
Entity
Organization
Contact information
Practice address
992 MANER DR, ALLENDALE, SC 29810-4334
(912) 682-7892
Mailing address
992 MANER DR, ALLENDALE, SC 29810-4334
(912) 682-7892
Taxonomy
Speciality
Code
Description
License number
State
163WC1600X
Continuing Education/Staff Development Registered Nurse
Primary
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
06/14/2017
Last updated
04/25/2024
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