Healthcare Provider Details

I. General information

NPI: 1558202630
Provider Name (Legal Business Name): SHAKTI SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 RED VENTURES DR
FORT MILL SC
29707-1101
US

IV. Provider business mailing address

851 PECAN TREE LN
FORT MILL SC
29715-7010
US

V. Phone/Fax

Practice location:
  • Phone: 704-907-0524
  • Fax:
Mailing address:
  • Phone: 704-907-0524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. PALAK HARSH AMIN
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 731-589-8118