Provider Demographics
NPI:1083672935
Name:NEW GENERATIONS ADULT DAY CENTER, INC.
Entity Type:Organization
Organization Name:NEW GENERATIONS ADULT DAY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:B
Authorized Official - Last Name:BELISSARY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:843-629-0103
Mailing Address - Street 1:1521C S IRBY ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-3409
Mailing Address - Country:US
Mailing Address - Phone:843-629-0103
Mailing Address - Fax:843-629-1334
Practice Address - Street 1:1521C S IRBY ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-3409
Practice Address - Country:US
Practice Address - Phone:843-629-0103
Practice Address - Fax:843-629-1334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCADC-149311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCADC-149OtherDHEC LICENSE
SCEX0599Medicaid