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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