Basic Information
| Provider Information | |||||||||
| NPI: | 1780795369 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAREBRIDGE ADULT DAY CARE CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 230 GILES DR | ||||||||
| Address2: | |||||||||
| City: | BOILING SPRINGS | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293166036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645997342 | ||||||||
| FaxNumber: | 8645990479 | ||||||||
| Practice Location | |||||||||
| Address1: | 230 GILES DR | ||||||||
| Address2: | |||||||||
| City: | BOILING SPRINGS | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293166036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645997342 | ||||||||
| FaxNumber: | 8645990479 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ROGERS | ||||||||
| AuthorizedOfficialFirstName: | JOANNE | ||||||||
| AuthorizedOfficialMiddleName: | MCMILLIN | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8645997342 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | 1/3 PARTNER | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA0600X | ADC-263 | SC | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care |
No ID Information.