# MARANATHA MANOR OF SPARTANBURG, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962480186
- **Authorized official:** MS. SANDRA M WEST (OFFICE MANAGER)
- **Authorized official phone:** (864) 579-0086

## Contact information

- **Practice address:** 2902 E MAIN STREET EXT, SPARTANBURG, SC 29307-1252
- **Practice address phone:** (864) 579-0086
- **Practice address fax:** (864) 579-0466
- **Mailing address:** 2902 E MAIN STREET EXT, SPARTANBURG, SC 29307-1252
- **Mailing address phone:** (864) 579-0086
- **Mailing address fax:** (864) 579-0466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | CRC1235 | SC | Yes |

## Other

- **Enumeration date:** 01/06/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | RC1235 | — | SC |