Organization Active NPI

Johnsonville Adult Care Services, LLC

  • Assisted Living Facility
  • Johnsonville, SC
National Provider Identifier
1366780298
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
CRC-1530 Issued in SC
Legal business name
JOHNSONVILLE ADULT CARE SERVICES, LLC
Practice address
351 S. Midway Highway
Johnsonville, SC 29555
Phone
(843) 380-0777
Fax
(843) 380-1571
NPI assigned
Jan 28, 2013
Last updated
Jan 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Rhonda Hart Robinson
Title
Administrator
Phone
(843) 625-1290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X CRC-1530 SC Primary

Addresses

Primary practice location

351 S. Midway Highway
Johnsonville, SC 29555

Mailing address

351 S. Midway Highway
P.O. Box 1118
Johnsonville, SC 29555
Phone (843) 380-0777

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2209210Johnsonville Adult Care Services351 S Midway Hwy, Johnsonville, SC 29555Certificate of waiverJan 11, 2027

National Provider Directory

National Provider Directory

Locations

351 S Midway Hwy
Johnsonville, SC 29555
Phone (843) 380-0777

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359331200000",
    "number": "1366780298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 S. MIDWAY HIGHWAY",
            "address_2": "P.O. BOX 1118",
            "city": "JOHNSONVILLE",
            "state": "SC",
            "postal_code": "29555",
            "telephone_number": "843-380-0777",
            "fax_number": "843-380-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 S. MIDWAY HIGHWAY",
            "city": "JOHNSONVILLE",
            "state": "SC",
            "postal_code": "29555",
            "telephone_number": "843-380-0777",
            "fax_number": "843-380-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSONVILLE ADULT CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-28",
        "last_updated": "2013-01-28",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "HART",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "843-625-1290",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SC",
            "license": "CRC-1530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.