Provider Demographics
NPI:1285317784
Name:ADULT DAY ACTIVITIES SAMARITANS LLC
Entity type:Organization
Organization Name:ADULT DAY ACTIVITIES SAMARITANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LYDELL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-351-8351
Mailing Address - Street 1:PO BOX 1448
Mailing Address - Street 2:
Mailing Address - City:TRAVELERS REST
Mailing Address - State:SC
Mailing Address - Zip Code:29690-1204
Mailing Address - Country:US
Mailing Address - Phone:864-842-2327
Mailing Address - Fax:864-897-9913
Practice Address - Street 1:509 S LEWIS ST
Practice Address - Street 2:
Practice Address - City:PICKENS
Practice Address - State:SC
Practice Address - Zip Code:29671-2521
Practice Address - Country:US
Practice Address - Phone:864-351-8351
Practice Address - Fax:864-689-1200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care