Healthcare Provider Details

I. General information

NPI: 1831228105
Provider Name (Legal Business Name): EAST COOPER SENIOR DAY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 LAKE HUNTER CIR STE C
MOUNT PLEASANT SC
29464-5427
US

IV. Provider business mailing address

999 LAKE HUNTER CIR STE C
MOUNT PLEASANT SC
29464-5427
US

V. Phone/Fax

Practice location:
  • Phone: 843-216-1070
  • Fax: 843-216-2470
Mailing address:
  • Phone: 843-216-1070
  • Fax: 843-216-2470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberADC228
License Number StateSC

VIII. Authorized Official

Name: MRS. SUSAN SALE
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 843-216-1070