Provider Demographics
NPI:1053753814
Name:UPSTATE HOME CARE LLC
Entity type:Organization
Organization Name:UPSTATE HOME CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLIENT CARE
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:VERDIN
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:864-438-2996
Mailing Address - Street 1:24 WOODS LAKE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607
Mailing Address - Country:US
Mailing Address - Phone:864-438-2995
Mailing Address - Fax:864-438-0887
Practice Address - Street 1:24 WOODS LAKE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607
Practice Address - Country:US
Practice Address - Phone:864-438-2995
Practice Address - Fax:864-438-0887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health