Provider Demographics
NPI:1639651987
Name:ARIES HOME CARE LLC
Entity type:Organization
Organization Name:ARIES HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DAHYOJENDAYI
Authorized Official - Middle Name:LENAIR
Authorized Official - Last Name:FULLWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-491-1636
Mailing Address - Street 1:3236 LANDMARK DR STE 121
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-8490
Mailing Address - Country:US
Mailing Address - Phone:843-737-4896
Mailing Address - Fax:843-737-4896
Practice Address - Street 1:3236 LANDMARK DR STE 121
Practice Address - Street 2:
Practice Address - City:N CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-8490
Practice Address - Country:US
Practice Address - Phone:866-491-1636
Practice Address - Fax:437-374-8968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-04
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251E00000X, 253Z00000X
332BX2000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX1951Medicaid
8RT04OtherSAM.GOV