Provider Demographics
NPI:1871616680
Name:SCOTLAND COUNTY ADULT DAY SERVICES
Entity type:Organization
Organization Name:SCOTLAND COUNTY ADULT DAY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-276-4554
Mailing Address - Street 1:425 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-3818
Mailing Address - Country:US
Mailing Address - Phone:910-276-4554
Mailing Address - Fax:910-276-9864
Practice Address - Street 1:425 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-3818
Practice Address - Country:US
Practice Address - Phone:910-276-4554
Practice Address - Fax:910-276-9864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409292Medicaid