| Miranda Willis Adult Day Care, Llc | |
|
5932 Mcmillian Circle Columbia SC 29212 | |
| (803) 586-7455 | |
| Not Available |
| Full Name | Miranda Willis Adult Day Care, Llc |
|---|---|
| Speciality | Clinic/center - Adult Day Care |
| Location | 5932 Mcmillian Circle, Columbia, South Carolina |
| Authorized Official Name and Position | Crystal M Willis (CEO) |
| Authorized Official Contact | 8035867455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miranda Willis Adult Day Care, Llc 5932 Mcmillian Circle Columbia SC 29212 Ph: (803) 586-7455 | Miranda Willis Adult Day Care, Llc 5932 Mcmillian Circle Columbia SC 29212 Ph: (803) 586-7455 |
| NPI Number | 1902215296 |
|---|---|
| Provider Enumeration Date | 08/12/2014 |
| Last Update Date | 08/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902215296 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 10532 (South Carolina) | Secondary |
| 261QA0600X | Clinic/center - Adult Day Care | (* (Not Available)) | Primary |
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