Organization
EDDIE D ISHAM
Active
Other names
ALONJAY ADULT DAYCARE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDDIE DEAN ISHAM SR. (CO-OWNER)
(803) 584-1333
Entity
Organization
Contact information
Practice address
567 PATTERSON ST, ALLENDALE, SC 29810-6027
(803) 584-1333
(803) 584-7001
Mailing address
567 PATTERSON ST, ALLENDALE, SC 29810-6027
(803) 584-1333
(803) 584-7001
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
191
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EX0623
—
SC
Enumeration date
02/26/2008
Last updated
07/01/2008
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