Organization
FAIRFIELD HOME, LLC
Active
Other names
Fairfield Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEVI RUDD (CEO)
(786) 358-5200
Entity
Organization
Contact information
Practice address
117 BELLFIELD ROAD, RIDGEWAY, SC 29130-8261
(803) 337-2257
Mailing address
1709 MILL STREET, CAMDEN, SC 29020-2730
(803) 337-2257
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0978
SC
314000000X
Skilled Nursing Facility
NH-776
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0776NF
—
SC
Enumeration date
10/07/2005
Last updated
04/20/2016
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