Provider Demographics
NPI:1104926328
Name:LTB CONSULTING SERVICES
Entity type:Organization
Organization Name:LTB CONSULTING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VEATRICE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-722-6355
Mailing Address - Street 1:13 ELMWOOD ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-4301
Mailing Address - Country:US
Mailing Address - Phone:843-722-6355
Mailing Address - Fax:843-722-2239
Practice Address - Street 1:13 ELMWOOD ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-4301
Practice Address - Country:US
Practice Address - Phone:843-722-6355
Practice Address - Fax:843-722-2239
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LTB CONSULTING SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-25
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCEX0802253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX0802Medicaid