Healthcare Provider Details
I. General information
NPI: 1629372172
Provider Name (Legal Business Name): NEW GENERATIONS ADULT DAY CENTER OF FLORENCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/27/2010
Last Update Date: 12/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2111 W. JODY ROAD
FLORENCE SC
29501
US
IV. Provider business mailing address
507 JASPER STATION SUITE 1
RIDGELAND SC
29936
US
V. Phone/Fax
- Phone: 843-629-0103
- Fax:
- Phone: 843-726-6077
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 311ZA0620X |
| Taxonomy | Adult Care Home Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
GAIL
BELISSARY
Title or Position: ADMINISTRATOR
Credential: RN, BSN
Phone: 843-629-0103