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Organization

PELNA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MOYOSORE AGIRI (ADMINSTRATOR)
(757) 288-3604
Entity
Organization

Contact information

Practice address
2012 HIGHWAY 160 W STE 19, FORT MILL, SC 29708-8401
(757) 717-8922
Mailing address
2012 HIGHWAY 160 W STE 19, FORT MILL, SC 29708-8401
(757) 717-8922

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
3747P1801X
Personal Care Attendant

Other

Enumeration date
03/04/2021
Last updated
03/04/2021
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