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General NPI Number Information
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NPI Number | 1700406998
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Entity Type | Organization
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Legal Business Name | NY'S ADULT DAY CARE, LLC
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Dates
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Enumeration Date | 04/17/2020
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 21 GARDEN AVENUE
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City | GEORGETOWN
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State | SC
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Zip | 29440-2925
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Country | US
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Telephone | 843-461-9010
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Fax | 843-527-4838
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Provider Business Mailing Address
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Address Line | PO BOX 2135
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City | GEORGETOWN
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State | SC
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Zip | 29442-2942
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Country | US
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Telephone | 843-240-2061
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Fax | 843-527-4838
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MAZIE ELIZABETH GRAHAM
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Credential | RN
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Telephone | 843-240-2061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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