Provider Demographics
NPI:1861220535
Name:BELOVED HOME HEALTHCARE OF THE CAROLINAS
Entity type:Organization
Organization Name:BELOVED HOME HEALTHCARE OF THE CAROLINAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NASIM
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-324-0190
Mailing Address - Street 1:229 DAVIDSON RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:SC
Mailing Address - Zip Code:29745-7556
Mailing Address - Country:US
Mailing Address - Phone:803-324-0190
Mailing Address - Fax:803-324-0191
Practice Address - Street 1:2025 EBENEZER RD STE K
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1062
Practice Address - Country:US
Practice Address - Phone:803-324-0190
Practice Address - Fax:803-324-0191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty