Provider Demographics
NPI:1215327069
Name:ADDUS HEALTHCARE (SOUTH CAROLINA), INC.
Entity type:Organization
Organization Name:ADDUS HEALTHCARE (SOUTH CAROLINA), INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EVP, CHIEF STRATEGY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DARBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-296-3443
Mailing Address - Street 1:2300 WARRENVILLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1717
Mailing Address - Country:US
Mailing Address - Phone:630-296-3530
Mailing Address - Fax:
Practice Address - Street 1:7332 YANKEE RD
Practice Address - Street 2:
Practice Address - City:LIBERTY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45044-9168
Practice Address - Country:US
Practice Address - Phone:513-712-5030
Practice Address - Fax:513-712-5035
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADDUS HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-02-02
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health