Organization
HERMAN L. ANDERSON INC,
Active
Other names
Anderson Oaks Assisted Livinge
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE C FLECKNOE ADMINISTRATOR (ADMINISTRATOR)
(843) 347-9280
Entity
Organization
Contact information
Practice address
997 HIGHWAY 90, CONWAY, SC 29526-7520
(843) 347-9280
Mailing address
997 HIGHWAY 90, CONWAY, SC 29526-7520
(843) 347-9280
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
CRC-1506
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CRC-1506
FACILITY LICENSE
SC
Enumeration date
06/19/2014
Last updated
06/19/2014
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