| NPI | 1043655319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRYL ALAN MAST Administrator 864-621-4958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: SC CRC-0241) |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2017-12-27 |