Provider Demographics
NPI:1417111675
Name:CAROLINA-IN-HOME-AIDE,LLC
Entity type:Organization
Organization Name:CAROLINA-IN-HOME-AIDE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-591-2322
Mailing Address - Street 1:145 N CHURCH ST
Mailing Address - Street 2:BTC # 66
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29306-5123
Mailing Address - Country:US
Mailing Address - Phone:864-591-2322
Mailing Address - Fax:864-591-2323
Practice Address - Street 1:145 N CHURCH ST
Practice Address - Street 2:BTC #66
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-5123
Practice Address - Country:US
Practice Address - Phone:864-591-2322
Practice Address - Fax:864-591-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty