Healthcare Provider Details

I. General information

NPI: 1780736710
Provider Name (Legal Business Name): TOTAL COMFORT ADULT DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 CAMDEN RD
HOLLY HILL SC
29059
US

IV. Provider business mailing address

1706 CAMDEN RD
HOLLY HILL SC
29059
US

V. Phone/Fax

Practice location:
  • Phone: 803-496-1076
  • Fax: 803-496-7926
Mailing address:
  • Phone: 803-496-1076
  • Fax: 803-496-7926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. RONALD BRADSHAW
Title or Position: OWNER
Credential:
Phone: 803-496-1076