Organization
MOUNTAIN TOP ADULT DAY CENTER
Active
Other names
MTADC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROLYN A KENNEDY ED.D. (CHIEF EXECUTIVE OFFICER)
(803) 736-5872
Entity
Organization
Contact information
Practice address
1941 DECKER BLVD, COLUMBIA, SC 29206-3470
(803) 787-0020
(803) 787-0020
Mailing address
1941 DECKER BLVD, COLUMBIA, SC 29206-3470
(803) 787-0020
(803) 787-0020
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
2016-47738-46733
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EX1304
—
SC
Enumeration date
03/07/2016
Last updated
03/07/2016
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