Healthcare Provider Details

I. General information

NPI: 1972621217
Provider Name (Legal Business Name): CHAPPELL ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4340 JACKSON CREEK RD
WINNSBORO SC
29180-7800
US

IV. Provider business mailing address

4340 JACKSON CREEK RD
WINNSBORO SC
29180-7800
US

V. Phone/Fax

Practice location:
  • Phone: 803-712-0146
  • Fax: 803-712-0891
Mailing address:
  • Phone: 803-712-0146
  • Fax: 803-712-0891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberADC261
License Number StateSC

VIII. Authorized Official

Name: MRS. MALISSA CHAPPELL
Title or Position: DIRECTOR
Credential:
Phone: 803-712-0146