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Organization
SHAVAN, LLC
Active
Organization
SHAVAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON ELIZABETH SMITH (OWNER)
(803) 327-8655
Entity
Organization
Contact information
Practice address
127 S HERLONG AVE, ROCK HILL, SC 29732-1100
(803) 327-8655
Mailing address
PO BOX 2444, STEPHENVILLE, TX 76401-0040
(254) 918-5388
(844) 269-6826
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
03/02/2018
Last updated
03/02/2018
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