Organization
MARY RC F #3
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY D. BACOTE (OWNER)
(803) 556-9813
Entity
Organization
Contact information
Practice address
10219 FARROW RD, BLYTHEWOOD, SC 29016
(803) 683-7972
Mailing address
10219 FARROW RD, BLYTHEWOOD, SC 29016
(803) 683-7972
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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