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General NPI Number Information
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NPI Number | 1093030777
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Entity Type | Organization
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Legal Business Name | ADULT CARE OF THE CAROLINAS INC
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Dates
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Enumeration Date | 04/06/2010
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Last Update Date | 04/06/2010
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Provider Practice Location Address
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Address Line | 2860 NEW CUT RD
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City | SPARTANBURG
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State | SC
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Zip | 29303-6332
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Country | US
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Telephone | 864-439-7347
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Fax |
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Provider Business Mailing Address
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Address Line | 936 7TH ST SUITE B #129
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City | NOVATO
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State | CA
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Zip | 94945-3010
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Country | US
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Telephone | 480-444-9956
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Fax | 480-323-2371
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GARY JACOBS
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Credential |
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Telephone | 480-444-9956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | CRC-0384
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License Number State | SC
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