| NPI | 1356872766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY OWENS Office Manager 803-757-1173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: SC 20784) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: SC 20784) |
| 314000000X Skilled Nursing Facility (Licence: SC 20784) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2017-03-27 |