Organization
DESTINE TO DEFINE HOMECARE AGENCY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TRACY FLOOD (OWNER/DIRECTOR)
(803) 347-3930
Entity
Organization
Contact information
Practice address
969 DANTZLER ST, ORANGEBURG, SC 29115-4321
(803) 387-2273
Mailing address
1910 KENNERLY RD, ORANGEBURG, SC 29118-9156
(803) 347-3930
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/03/2019
Last updated
01/03/2019
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