| NPI | 1578757811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE BURGESS HICKSON Nurse 843-389-9024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2007-08-29 |