Provider Demographics
NPI:1629372172
Name:NEW GENERATIONS ADULT DAY CENTER OF FLORENCE, INC.
Entity Type:Organization
Organization Name:NEW GENERATIONS ADULT DAY CENTER OF FLORENCE, INC.
Other - Org Name:NEW GENERATIONS ADULT DAY CENTER OF RIDGELAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BELISSARY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:843-629-0103
Mailing Address - Street 1:507 JASPER STATION
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RIDGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29936
Mailing Address - Country:US
Mailing Address - Phone:843-726-6077
Mailing Address - Fax:
Practice Address - Street 1:2111 W. JODY ROAD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501
Practice Address - Country:US
Practice Address - Phone:843-629-0103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW GENERATIONS ADULT DAY CENTER OF FLORENCE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEN1073Medicaid