Organization
WILLOW CREEK LIVING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN F. SWIFT (VP & CFO)
(864) 269-3725
Entity
Organization
Contact information
Practice address
406 WEST BROAD STREET, IVA, SC 29655
(864) 348-7433
(864) 348-3888
Mailing address
101 GRACE DR, EASLEY, SC 29640-9088
(864) 269-3725
(864) 295-3383
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCF-682
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0682 NF
—
SC
Enumeration date
07/17/2006
Last updated
03/10/2008
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