NPIMap

Organization Active NPI

Conway Adult Day Care at Creel St.

  • Adult Day Care Clinic/Center
  • Conway, SC
National Provider Identifier
1902094147
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
ADC-278 Issued in SC
Legal business name
CONWAY ADULT DAY CARE AT CREEL ST.
Practice address
911 Creel St
Conway, SC 29527-5001
Phone
(843) 488-4855
Fax
(843) 488-4857
NPI assigned
Oct 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Authorized official

Name
Donna Valentine Vance
Title
Vice President
Phone
(843) 450-3497

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X ADC-278 SC Primary

Addresses

Primary practice location

911 Creel St
Conway, SC 29527-5001

Mailing address

11919 Plaza Dr
Murrells Inlet, SC 29576-9356
Phone (843) 652-0011

National Provider Directory

National Provider Directory

Locations

911 Creel St
Conway, SC 29527
Phone (843) 488-4001

NPI Registry JSON

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1902094147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11919 PLAZA DR",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295769356",
            "telephone_number": "843-652-0011",
            "fax_number": "843-369-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 CREEL ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295275001",
            "telephone_number": "843-488-4855",
            "fax_number": "843-488-4857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY ADULT DAY CARE AT CREEL ST.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "VANCE",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "VALENTINE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "843-450-3497"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "SC",
            "license": "ADC-278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.