Individual
LATEISHA CHANETTE BEARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3112 NORTH RD, ORANGEBURG, SC 29118-2805
(803) 937-6961
Mailing address
4236 STILLWOOD CIR, ORANGEBURG, SC 29118-1565
(713) 502-7643
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
IHCP-2318
SC
253Z00000X
In Home Supportive Care Agency
IHCP-2318
SC
374U00000X
Home Health Aide
IHCP-2318
SC
Other
Enumeration date
10/10/2024
Last updated
12/03/2024
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