Healthcare Provider Details

I. General information

NPI: 1790601441
Provider Name (Legal Business Name): CAROLINA DAY HAVEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 EBENEZER RD
ROCK HILL SC
29732-2339
US

IV. Provider business mailing address

613 DALLAS ST
CHESTER SC
29706-2538
US

V. Phone/Fax

Practice location:
  • Phone: 803-374-3062
  • Fax:
Mailing address:
  • Phone: 803-374-3062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BEVERLY RILEY
Title or Position: OWNER
Credential:
Phone: 803-374-3062