Healthcare Provider Details

I. General information

NPI: 1407041924
Provider Name (Legal Business Name): GINGER'S ADULT DAY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 09/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W MARTINTOWN RD # A
NORTH AUGUSTA SC
29841-3194
US

IV. Provider business mailing address

202 E CROSSON ST
LEESVILLE SC
29070-9022
US

V. Phone/Fax

Practice location:
  • Phone: 803-279-7822
  • Fax:
Mailing address:
  • Phone: 803-279-7822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number11010
License Number StateSC

VIII. Authorized Official

Name: MRS. ALVERNEQ HATTAE SIMPKINS
Title or Position: CO-ADMINISTRATOR
Credential:
Phone: 803-279-7822