Organization
WILDEWOOD RETIREMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN THOMPSON (MANAGER)
(704) 815-7341
Entity
Organization
Contact information
Practice address
731 POLO RD, COLUMBIA, SC 29223-4462
(803) 788-5115
Mailing address
3530 TORINGDON WAY STE 204, CHARLOTTE, NC 28277-3436
(704) 246-1620
(704) 246-1621
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
05/03/2019
Last updated
05/03/2019
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