Healthcare Provider Details

I. General information

NPI: 1871374611
Provider Name (Legal Business Name): NOLAN ADULT DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 ORCHARD PARK DR STE 14
GREENVILLE SC
29615-3500
US

IV. Provider business mailing address

30 ORCHARD PARK DR STE 14
GREENVILLE SC
29615-3500
US

V. Phone/Fax

Practice location:
  • Phone: 864-373-3516
  • Fax:
Mailing address:
  • Phone: 864-373-3516
  • 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: MR. QUINCY NOLAN
Title or Position: EX DIRECTOR
Credential:
Phone: 864-373-3516