1609387497 NPI number — CAROLINAS CAREGIVERS ENTERPRISES, LLC

Table of content: (NPI 1609387497)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609387497 NPI number — CAROLINAS CAREGIVERS ENTERPRISES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAROLINAS CAREGIVERS ENTERPRISES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609387497
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
454 ANDERSON RD S # BTC563
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCK HILL
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29730-3392
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-329-8333
Provider Business Mailing Address Fax Number:
888-780-7384

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
454 ANDERSON RD S STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCK HILL
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29730-3398
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-329-8333
Provider Business Practice Location Address Fax Number:
888-780-7384
Provider Enumeration Date:
10/19/2017

Additional Information

Authorized Official

Authorized Official Last Name:
SKELTON
Authorized Official First Name:
CHARLENE
Authorized Official Middle Name:
WITCHER
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
803-329-8333

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  IHCP-0747 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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