MEDICARE: UPSTATE SENIOR CARE LLC, DBA AMADA SENIOR CARE SIMPSONVILLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1619835956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPSTATE SENIOR CARE LLC, DBA AMADA SENIOR CARE SIMPSONVILLE

Provider Business Mailing Address
First Line	:	133 WOODRUFF PLACE CIR STE 50
Second Line	:
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29681-3672
Country	:	US
Telephone Number	:	864-409-8044
Fax Number	:	864-409-8044

Provider Business Practice Location Address
First Line	:	133 WOODRUFF PLACE CIR STE 50
Second Line	:
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29681-3672
Country	:	US
Telephone Number	:	864-409-8044
Fax Number	:	864-409-8044

Authorized Official
Title or Position	:	OWNER / DIRECTOR
Name	:	GEOFFREY STINEBAUGH
Credential	:
Telephone Number	:	864-409-8044

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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