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Organization
THI OF SOUTH CAROLINA AT SPARTANBURG, LLC
Active
Organization
THI OF SOUTH CAROLINA AT SPARTANBURG, LLC
Active
Other names
Magnolia Manor of Spartanburg
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HILSEN (PRESIDENT)
(864) 585-0218
Entity
Organization
Contact information
Practice address
375 SERPENTINE DR, SPARTANBURG, SC 29303-3026
(864) 585-0218
(864) 594-5122
Mailing address
930 RIDGEBROOK RD, SPARKS, MD 21152-9390
(410) 773-1000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0867NF
—
SC
Enumeration date
10/07/2006
Last updated
04/07/2008
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