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General NPI Number Information
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NPI Number | 1538071188
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Entity Type | Organization
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Legal Business Name | A SENIOR CARE LIFELINE LLC
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | 1320 HIGHWAY 501 BUSINESS UNIT B
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City | CONWAY
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State | SC
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Zip | 29526-9547
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Country | US
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Telephone | 843-742-5252
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Fax |
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Provider Business Mailing Address
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Address Line | 1320 HIGHWAY 501 BUSINESS UNIT B
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City | CONWAY
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State | SC
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Zip | 29526-9547
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Country | US
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Telephone | 843-742-5252
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/FOUNDER
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Name | MR. RONDU KING JACKSON
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Credential | CEO
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Telephone | 843-742-5252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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