Organization
THI OF SOUTH CAROLINA AT MAGNOLIA MANORINMAN, LLC
Active
Other names
Magnolia Manor - Inman
Organization subpart
No
Provider details
NPI number
Authorized official
DALE LYLES (PRESIDENT)
(864) 472-9055
Entity
Organization
Contact information
Practice address
63 BLACKSTOCK RD, INMAN, SC 29349-1835
(864) 472-9055
(864) 472-2619
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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0863NF
—
SC
Enumeration date
10/07/2006
Last updated
04/07/2008
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