MRS. CHERYL RENEE GIBSON-DALTON PRESIDENT AND CEO NPI 1346634904

NPI Information

NPI: 1346634904
Provider Name: MRS. CHERYL RENEE GIBSON-DALTON, PRESIDENT AND CEO
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Individual

Specialization: Adult Care Home

Address:
1231 EUTAW ST
ORANGEBURG, SC
ZIP 29115
Phone: (803) 531-6534
Get Directions

MRS. Cheryl Renee Gibson-dalton, PRESIDENT AND CEO is an adult care home custodial care facility in Orangeburg, SC. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. MRS. Cheryl Renee Gibson-dalton, PRESIDENT AND CEO NPI is 1346634904. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1231 EUTAW ST
ORANGEBURG, SC
ZIP 29115-529
Phone: (803) 531-6534
Fax: (803) 531-6534

The enumeration date for this NPI number is 3/22/2015 and was last updated on 3/22/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	311ZA0620X	Custodial Care Facility	Adult Care Home	RC1447	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CRC1447	OTHER	SOUTH CAROLINA	MEDICAID OSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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