Organization
ASSURANCE COMMUNITY LONG TERM CARE LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE DIONNE BROWN (ADMINISTRATOR/CEO)
(809) 396-8950
Entity
Organization
Contact information
Practice address
2012 HIGHWAY 160 W, FORT MILL, SC 29708-8401
(803) 396-8950
Mailing address
2012 HIGHWAY 160 W, FORT MILL, SC 29708-8401
(803) 396-8950
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EX1025
—
SC
Enumeration date
04/15/2010
Last updated
04/27/2010
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