Healthcare Provider Details

I. General information

NPI: 1497924039
Provider Name (Legal Business Name): TRI-COUNTY ADULT DAY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2008
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 CALVARY LANE
CHERAW SC
29520-0000
US

IV. Provider business mailing address

PO BOX 186
CHERAW SC
29520-0186
US

V. Phone/Fax

Practice location:
  • Phone: 843-921-9451
  • Fax: 843-921-9453
Mailing address:
  • Phone: 843-921-9451
  • Fax: 843-921-9453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN E SCOTT
Title or Position: RN
Credential:
Phone: 843-921-9451