Basic Information
| Provider Information | |||||||||
| NPI: | 1720046642 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW GENERATIONS HOME CARE INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1521C S IRBY ST | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295053409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436290794 | ||||||||
| FaxNumber: | 8436290103 | ||||||||
| Practice Location | |||||||||
| Address1: | 1521 C. SOUTH IRBY STREET | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436290794 | ||||||||
| FaxNumber: | 8436291334 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BELISSARY | ||||||||
| AuthorizedOfficialFirstName: | GAIL | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8436290794 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RN,BSN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WH0200X | X | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Nursing Service Providers | Registered Nurse | Home Health | 374U00000X | X | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Nursing Service Related Providers | Home Health Aide |
ID Information
| ID | Type | State | Issuer | Description | X0575 | 05 | SC | MEDICAID |