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Organization
BLACKVILLE HEALTHCARE AND REHAB, LLC
Active
Organization
BLACKVILLE HEALTHCARE AND REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAIM CY PIZAM (MANAGING MEMBER)
(407) 454-9096
Entity
Organization
Contact information
Practice address
1612 JONES BRIDGE RD, BLACKVILLE, SC 29817-3066
(803) 284-4313
(803) 284-1746
Mailing address
1612 JONES BRIDGE RD, BLACKVILLE, SC 29817-3066
(803) 284-4313
(803) 284-1746
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH-755
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NCF-1038
DHEC LIC #
SC
Enumeration date
08/27/2005
Last updated
10/17/2019
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