Upstate Living Water, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

UPSTATE LIVING WATER, LLC

Practice address

102 Parkins Mill Rd
Greenville, SC 29607-2932

Phone

(864) 569-5977

NPI assigned

Aug 3, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Orville Keith Hogancamp

Title

Owner

Phone

(864) 569-5977

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1740768464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PARKINS MILL RD UNIT A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072932",
            "telephone_number": "864-569-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PARKINS MILL RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072932",
            "telephone_number": "864-569-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE LIVING WATER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-03",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "HOGANCAMP",
        "authorized_official_first_name": "ORVILLE",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-569-5977"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IHCP-0754",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Greenville, SC
• Providers in Greenville, SC by specialty
• Home Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.