Healthcare Provider Details

I. General information

NPI: 1164927166
Provider Name (Legal Business Name): ALL ABOUT OUR SENIORS ADULT DAY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 W POINSETT ST
GREER SC
29650-1250
US

IV. Provider business mailing address

1306 W POINSETT ST
GREER SC
29650-1250
US

V. Phone/Fax

Practice location:
  • Phone: 864-479-9111
  • Fax: 866-562-4804
Mailing address:
  • Phone: 864-469-7192
  • Fax: 866-562-4804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberADC-0432
License Number StateSC

VIII. Authorized Official

Name: TANIKA LAVET WALLACE
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 864-469-7192