Provider First Line Business Practice Location Address: 
1048 BRADLEY MILL ROAD
    Provider Second Line Business Practice Location Address: 
RESPITE CARE OF AIKEN
    Provider Business Practice Location Address City Name: 
AIKEN
    Provider Business Practice Location Address State Name: 
SC
    Provider Business Practice Location Address Postal Code: 
29805-1048
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
803-644-2785
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
05/14/2007