Provider Demographics
NPI:1164061982
Name:MARGARET'S GARDEN ADULT DAYCARE LLC
Entity Type:Organization
Organization Name:MARGARET'S GARDEN ADULT DAYCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DOREAN
Authorized Official - Middle Name:DELORES
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:304-228-7920
Mailing Address - Street 1:119 BEATTY LN
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-7600
Mailing Address - Country:US
Mailing Address - Phone:803-226-0099
Mailing Address - Fax:803-226-0229
Practice Address - Street 1:119 BEATTY LN
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-7600
Practice Address - Country:US
Practice Address - Phone:803-226-0099
Practice Address - Fax:803-226-0229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX1380Medicaid