Provider Demographics
NPI:1053748707
Name:ART OF DAILY LIVING, INC
Entity type:Organization
Organization Name:ART OF DAILY LIVING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LATAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:843-253-5034
Mailing Address - Street 1:PO BOX 1272
Mailing Address - Street 2:
Mailing Address - City:CHERAW
Mailing Address - State:SC
Mailing Address - Zip Code:29520-1272
Mailing Address - Country:US
Mailing Address - Phone:843-253-5034
Mailing Address - Fax:843-253-5187
Practice Address - Street 1:327 CHESTERFIELD HYW
Practice Address - Street 2:
Practice Address - City:CHERAW
Practice Address - State:SC
Practice Address - Zip Code:29520-1272
Practice Address - Country:US
Practice Address - Phone:843-253-5034
Practice Address - Fax:843-253-5187
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ART OF DAILY LIVING, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-26
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5514101YM0800X
SC17625364SF0001X
SC17462364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC152BHSMedicaid