Provider Demographics
NPI:1285283515
Name:UNIQ CARE
Entity type:Organization
Organization Name:UNIQ CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-593-1048
Mailing Address - Street 1:PO BOX 103
Mailing Address - Street 2:
Mailing Address - City:HEMINGWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29554-0103
Mailing Address - Country:US
Mailing Address - Phone:843-593-1048
Mailing Address - Fax:
Practice Address - Street 1:36450 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:HEMINGWAY
Practice Address - State:SC
Practice Address - Zip Code:29554-4328
Practice Address - Country:US
Practice Address - Phone:843-593-1048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNAMedicaid