Organization
CARLYLE SENIOR CARE OF FOUNTAIN INN,LLC
Active
Other names
Fountain Inn Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD S CRANFORD (CEO)
(843) 799-0756
Entity
Organization
Contact information
Practice address
501 GULLIVER ST, FOUNTAIN INN, SC 29644-2105
(864) 862-2554
(864) 862-9702
Mailing address
501 GULLIVER ST, FOUNTAIN INN, SC 29644-2105
(864) 862-2554
(864) 862-9702
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0626NH
—
SC
Enumeration date
07/29/2006
Last updated
02/10/2026
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