Provider Demographics
NPI:1235987413
Name:STEADFAST HOME CARE AND SENIOR SERVICES
Entity type:Organization
Organization Name:STEADFAST HOME CARE AND SENIOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GIST-BARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-404-4662
Mailing Address - Street 1:140 STONERIDGE DR STE 430
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-8276
Mailing Address - Country:US
Mailing Address - Phone:803-239-4780
Mailing Address - Fax:803-233-3250
Practice Address - Street 1:140 STONERIDGE DR STE 430
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-8276
Practice Address - Country:US
Practice Address - Phone:803-239-4780
Practice Address - Fax:803-233-3250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care