| NPI | 1639123748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND TILLER Administrator 843-248-5728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: SC NCF-899) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2010-01-11 |