Organization
QUILLEN MANOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY PHILLIP RICHMOND (EXECUTIVE DIRECTOR)
(864) 862-3252
Entity
Organization
Contact information
Practice address
709 QUILLEN AVE, FOUNTAIN INN, SC 29644-9444
(864) 862-3252
(864) 862-3254
Mailing address
709 QUILLEN AVE, FOUNTAIN INN, SC 29644-9444
(864) 862-3252
(864) 862-3254
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
CRC-1321
SC
Other
Enumeration date
03/15/2010
Last updated
03/15/2010
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