Organization
GENTLE CARE PROVIDER LLG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE DIANE WILSON (OWNER)
(843) 503-5152
Entity
Organization
Contact information
Practice address
917 PINT CIR, LONGS, SC 29568-7416
(843) 360-1655
Mailing address
PO BOX 4403, NORTH MYRTLE BEACH, SC 29597-4403
(843) 360-6155
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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