Healthcare Provider Details

I. General information

NPI: 1417710567
Provider Name (Legal Business Name): ADULT ENRICHMENT CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 02/01/2024
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

359 PARK AVE
ROCK HILL SC
29730-4025
US

IV. Provider business mailing address

PO BOX 2444
ROCK HILL SC
29732-4444
US

V. Phone/Fax

Practice location:
  • Phone: 180-332-7012
  • Fax:
Mailing address:
  • Phone: 803-327-0121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SAMANTHA KRIEGSHAUSER
Title or Position: CEO
Credential:
Phone: 803-327-0121