Provider Demographics
NPI:1013113281
Name:PALMETTO SENIOR DAYCARE
Entity Type:Organization
Organization Name:PALMETTO SENIOR DAYCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GOWDHAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:864-222-2770
Mailing Address - Street 1:1403 EAST GREENVILLE STREET
Mailing Address - Street 2:SUITE D
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-2049
Mailing Address - Country:US
Mailing Address - Phone:864-222-2770
Mailing Address - Fax:864-222-2780
Practice Address - Street 1:1403 EAST GREENVILLE STREET
Practice Address - Street 2:SUITE D
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-2049
Practice Address - Country:US
Practice Address - Phone:864-222-2770
Practice Address - Fax:864-222-2780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care