Wellformed AI

NPI 1538071188 · live from the CMS NPI Registry

A Senior Care Lifeline LLC

Dietitian, Registered in Conway, SC. National Provider Identifier 1538071188, active.

NPI record

NPI1538071188 Type 2 · organization
StatusActive
Primary specialtyDietitian, Registered 133V00000X
Practice location1320 Highway 501 Business Unit B, Conway, SC 29526
Practice phone843-742-5252
EnumeratedSeptember 18, 2026
Last updatedSeptember 18, 2026
Authorized officialRondu Jackson, President/Founder
Other namesMedirides

Taxonomies and licenses

TaxonomyCodeLicense
Nutritionist, Nutrition, Education133NN1002X—
Dietitian, Registered primary133V00000X—
Registered Nurse163W00000X—
Meals174200000X—
Massage Therapist225700000X—
Home Health251E00000X—
Home Delivered Meals332U00000X—
Non-emergency Medical Transport (VAN)343900000X—
Private Vehicle347C00000X—
Homemaker376J00000X—
Respite Care385H00000X—

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.