| NPI | 1346729050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY RICHARDSON Authorized Offical 803-290-1783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2018-08-13 |