NPIMap

Organization Active NPI

Lake City Community Day Services, Inc.

  • Health Maintenance Organization
  • Lake City, SC
National Provider Identifier
1801972542
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
SDC-252 Issued in SC
Legal business name
LAKE CITY COMMUNITY DAY SERVICES, INC.
Practice address
411 S Blanding St
Pob 517
Lake City, SC 29560-3513
Phone
(184) 337-4808
Fax
(784) 337-4538
NPI assigned
Oct 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

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

Authorized official

Name
Mrs. Earline James
Title
Director/Owner
Phone
(843) 374-8088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X SDC-252 SC Primary

Addresses

Primary practice location

411 S Blanding St
Pob 517
Lake City, SC 29560-3513

Mailing address

PO Box 517
411 S Blanding St
Lake City, SC 29560
Phone (843) 374-8088

Other names 1

  • Genesis I Adult Day Care Services, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Genesis I Adult Day Care Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1801972542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 517",
            "address_2": "411 S BLANDING ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "29560",
            "telephone_number": "843-374-8088",
            "fax_number": "843-374-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S BLANDING ST",
            "address_2": "POB 517",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295603513",
            "telephone_number": "184-337-4808",
            "fax_number": "784-337-4538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CITY COMMUNITY DAY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "EARLINE",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "843-374-8088",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "SC",
            "license": "SDC-252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis I Adult Day Care Services, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lake City, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; 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.