| NPI | 1679050868 |
|---|---|
| Doing Business As | GOOSE CREEK MANOR |
| Entity Type | Organization |
| Authorized Contact | FUZAIL A RIZVI President 571-225-8735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: SC CRC-2028) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: SC CRC-2027) |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2023-04-07 |