Healthcare Provider Details

I. General information

NPI: 1780795369
Provider Name (Legal Business Name): CAREBRIDGE ADULT DAY CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 GILES DR
BOILING SPRINGS SC
29316-6036
US

IV. Provider business mailing address

230 GILES DR
BOILING SPRINGS SC
29316-6036
US

V. Phone/Fax

Practice location:
  • Phone: 864-599-7342
  • Fax: 864-599-0479
Mailing address:
  • Phone: 864-599-7342
  • Fax: 864-599-0479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberADC-263
License Number StateSC

VIII. Authorized Official

Name: MRS. JOANNE MCMILLIN ROGERS
Title or Position: ADMINISTRATOR
Credential: 1/3 PARTNER
Phone: 864-599-7342