Organization
THI OF SOUTH CAROLINA AT MONCKS CORNER, LLC
Active
Other names
Magnolia Manor - Moncks Corner
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY JOHNS (PRESIDENT)
(843) 761-8368
Entity
Organization
Contact information
Practice address
505 S LIVE OAK DR, MONCKS CORNER, SC 29461-3553
(843) 761-8368
(843) 761-5874
Mailing address
930 RIDGEBROOK RD, SPARKS, MD 21152-9390
(410) 773-1000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
10/07/2006
Last updated
08/22/2020
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