Organization
4TH TRIMESTER 411
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARCY MYRA RICHARDSON (OWNER)
(843) 816-0923
Entity
Organization
Contact information
Practice address
11 STEVENS CT, HILTON HEAD ISLAND, SC 29926-2781
(843) 816-0923
Mailing address
11 STEVENS CT, HILTON HEAD ISLAND, SC 29926-2781
(843) 816-0923
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
120419-0030
SC
Other
Enumeration date
05/13/2012
Last updated
05/13/2012
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