Provider Demographics
NPI:1336573526
Name:DEVOTED CARE, LLC
Entity type:Organization
Organization Name:DEVOTED CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBALE
Authorized Official - Middle Name:LANETTE
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-479-6297
Mailing Address - Street 1:7340 PARKLANE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-7644
Mailing Address - Country:US
Mailing Address - Phone:803-764-1163
Mailing Address - Fax:
Practice Address - Street 1:7340 PARKLANE RD STE 203
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-7644
Practice Address - Country:US
Practice Address - Phone:803-763-1163
Practice Address - Fax:803-764-1164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-25
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management