| NPI | 1881079077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHONDA BELLAMY WILSON Supervisor 843-957-5888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: SC 313m00000x) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2015-07-29 |