Healthcare Provider Details

I. General information

NPI: 1902057433
Provider Name (Legal Business Name): ACTIVE DAY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2008
Last Update Date: 10/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 ENTERPRISE DR
FLORENCE SC
29501-1104
US

IV. Provider business mailing address

2120 ENTERPRISE DR
FLORENCE SC
29501-1104
US

V. Phone/Fax

Practice location:
  • Phone: 843-665-1919
  • Fax:
Mailing address:
  • Phone: 843-665-1919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number963
License Number StateSC

VIII. Authorized Official

Name: MRS. JEANNIE TURNER STRICKLAND
Title or Position: PTA
Credential:
Phone: 843-629-9377