Provider Demographics
NPI:1194849794
Name:COMMUNITY ADULT DAY CARE OF MARION, INC.
Entity Type:Organization
Organization Name:COMMUNITY ADULT DAY CARE OF MARION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:W
Authorized Official - Last Name:DE NITTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-423-6488
Mailing Address - Street 1:PO BOX 491
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:SC
Mailing Address - Zip Code:29571-0491
Mailing Address - Country:US
Mailing Address - Phone:843-423-6488
Mailing Address - Fax:
Practice Address - Street 1:310 EAST JONES AVE EXT
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:SC
Practice Address - Zip Code:29571
Practice Address - Country:US
Practice Address - Phone:843-423-6488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care