Provider Demographics
NPI:1144847070
Name:COMPANION CARE & HOSPICE ANGELS, LLC
Entity type:Organization
Organization Name:COMPANION CARE & HOSPICE ANGELS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OFFICE ADMI
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAS SMALLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-751-7158
Mailing Address - Street 1:PO BOX 22
Mailing Address - Street 2:
Mailing Address - City:ADAMS RUN
Mailing Address - State:SC
Mailing Address - Zip Code:29426-0022
Mailing Address - Country:US
Mailing Address - Phone:843-751-7158
Mailing Address - Fax:
Practice Address - Street 1:8310 TJ BLVD
Practice Address - Street 2:
Practice Address - City:ADAMS RUN
Practice Address - State:SC
Practice Address - Zip Code:29426
Practice Address - Country:US
Practice Address - Phone:843-751-7158
Practice Address - Fax:843-603-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No251B00000XAgenciesCase Management
No251G00000XAgenciesHospice Care, Community Based
No251K00000XAgenciesPublic Health or Welfare
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty