| NPI | 1396058301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAISY GREEN Owner/Director 803-943-2188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Additional Taxonomies | 347C00000X Private Vehicle |
| 251E00000X Home Health | |
| 253Z00000X In Home Supportive Care | |
| 305R00000X Preferred Provider Organization | |
| 305S00000X Point of Service | |
| 310400000X Assisted Living Facility | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2010-09-08 |