Organization
GRAND PALACE ACTIVITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNICE MONTGOMERY (CEO)
(803) 491-4426
Entity
Organization
Contact information
Practice address
1127 OLD POCALLO RD, SUMTER, SC 29150-7519
(803) 491-4426
(803) 774-0149
Mailing address
1105 VINTAGE DR, SUMTER, SC 29154-6121
(803) 491-4426
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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