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General NPI Number Information
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NPI Number | 1407041924
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Entity Type | Organization
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Legal Business Name | GINGER'S ADULT DAY CARE, LLC
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 09/07/2007
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Provider Practice Location Address
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Address Line | 401 W MARTINTOWN RD # A
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-3194
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Country | US
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Telephone | 803-279-7822
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Fax |
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Provider Business Mailing Address
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Address Line | 202 E CROSSON ST
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City | LEESVILLE
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State | SC
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Zip | 29070-9022
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Country | US
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Telephone | 803-279-7822
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Fax |
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Authorized Official
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Title or Position | CO-ADMINISTRATOR
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Name | MRS. ALVERNEQ HATTAE SIMPKINS
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Credential |
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Telephone | 803-279-7822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 11010
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License Number State | SC
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