Organization
MIRANDA WILLIS ADULT DAY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CRYSTAL M WILLIS LBSW, SW-G, CDP (CEO)
(803) 586-7455
Entity
Organization
Contact information
Practice address
5932 MCMILLIAN CIRCLE, COLUMBIA, SC 29212
(803) 586-7455
Mailing address
5932 MCMILLIAN CIRCLE, COLUMBIA, SC 29212
(803) 586-7455
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
10532
SC
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/12/2014
Last updated
08/15/2014
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