Provider Demographics
NPI:1639062797
Name:JUSTICE HOME CARE LLC
Entity type:Organization
Organization Name:JUSTICE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DOMONIQUE
Authorized Official - Middle Name:W
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-888-6037
Mailing Address - Street 1:1101 FIRST STREET SOUTH EXT STE D
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-3559
Mailing Address - Country:US
Mailing Address - Phone:803-888-6037
Mailing Address - Fax:803-888-6037
Practice Address - Street 1:1101 FIRST STREET SOUTH EXT STE D
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-3559
Practice Address - Country:US
Practice Address - Phone:803-888-6037
Practice Address - Fax:803-888-6037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care