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Organization

BLACK TIE SOUL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHEQUITA GORDON GORDON (OWNER)
(706) 461-7895
Entity
Organization

Contact information

Practice address
3017 NORHAM GARDENS LN, WARRENVILLE, SC 29851-3353
(706) 461-7895
Mailing address
3017 NORHAM GARDENS LN, WARRENVILLE, SC 29851-3353
(706) 461-7895

Taxonomy

Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary

Other

Enumeration date
04/24/2026
Last updated
04/24/2026
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