Organization
BELLA VISTA CONTINUED CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN ELAINE PETERSON (PRESIDENT)
(803) 206-3098
Entity
Organization
Contact information
Practice address
1435 BELLA VISTA DR, COLUMBIA, SC 29223-7201
(803) 206-3098
Mailing address
1535 PLATT SPRINGS ROAD #4283, WEST COLUMBIA, SC 29171
(803) 206-3098
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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