| NPI | 1679562078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERI GAMBILL Administrator 803-259-5547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: SC 314000000X) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2020-08-22 |