Delta Palms Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

DELTA PALMS ASSISTED LIVING LLC

Practice address

12488 Old Number Six Hwy # 6
Eutawville, SC 29048-9167

Phone

(843) 670-6051

NPI assigned

Aug 11, 2020

Last updated

Aug 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. James L Butler

Title

Owner

Phone

(843) 753-3920

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1568073849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 OLD HIGHWAY 6",
            "city": "CROSS",
            "state": "SC",
            "postal_code": "294363548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12488 OLD NUMBER SIX HWY # 6",
            "city": "EUTAWVILLE",
            "state": "SC",
            "postal_code": "290489167",
            "telephone_number": "843-670-6051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA PALMS ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-753-3920",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristianna L Bordelon, IBCLC
• Kelsey Gainey Campbell, LPN
• Care 1 Seniors Center
• Jennifer N Davis, IN HOME CARE PROVIDE
• Vernell Dottery
• Eutawville Pharmacy (Delta of Eutawville)
• Shakelia Fogle
• Harry Green Jr., MPT
• Jaunett James

• Assisted Living Facility in Eutawville, SC
• Providers in Eutawville, SC by specialty
• Assisted Living Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.