Healthcare Provider Details

I. General information

NPI: 1669776134
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

300 EAST JONES STREET EXTENSION
MARION SC
29571
US

V. Phone/Fax

Practice location:
  • Phone: 843-629-0103
  • Fax:
Mailing address:
  • Phone: 843-423-6488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: GAIL BELISSARY
Title or Position: ADMINISTRATOR
Credential: RN BSN
Phone: 843-629-0103