Organization
WOODRUFF MANOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA KAY TATUM LNHA (ADMINISTRATOR)
(864) 476-7092
Entity
Organization
Contact information
Practice address
1114 E GEORGIA RD, WOODRUFF, SC 29388-9350
(864) 476-7092
(864) 476-0753
Mailing address
1114 E GEORGIA RD, WOODRUFF, SC 29388-9350
(864) 476-7092
(864) 476-0753
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCF823
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0823NF
—
SC
Enumeration date
07/16/2006
Last updated
04/09/2008
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