1326371196 NPI number — D.A.V.& ELDERLY ASSISTANTS FOR LIFE,INC.

Table of content: (NPI 1326371196)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326371196 NPI number — D.A.V.& ELDERLY ASSISTANTS FOR LIFE,INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
D.A.V.& ELDERLY ASSISTANTS FOR LIFE,INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326371196
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 864
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIDGELAND
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29936-2615
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-473-2068
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
781 CHERRY HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIDGELAND
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29936-7653
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-473-2068
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/11/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WHITE
Authorized Official First Name:
CYNTHIA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
843-473-2068

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  2374 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 343900000X , with the licence number: 2374 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)