Provider Demographics
NPI:1902682701
Name:PEBBLES HELPING SENIORS LLC
Entity Type:Organization
Organization Name:PEBBLES HELPING SENIORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-470-0925
Mailing Address - Street 1:PO BOX 24
Mailing Address - Street 2:
Mailing Address - City:HARDEEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29927-0024
Mailing Address - Country:US
Mailing Address - Phone:843-470-0925
Mailing Address - Fax:843-887-8231
Practice Address - Street 1:206 SEA ISLAND PKWY
Practice Address - Street 2:
Practice Address - City:LADYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29907-1526
Practice Address - Country:US
Practice Address - Phone:843-470-0925
Practice Address - Fax:843-887-8231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty