Organization
FS TENANT POOL I TRUST
Active
Parent organization
FS TENANT POOL I TRUST
Other names
MYRTLE BEACH MANOR
Organization subpart
Yes
Provider details
NPI number
Legal business name
FS TENANT POOL I TRUST
Authorized official
KATHERINE E POTTER (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(617) 796-8387
Entity
Organization
Contact information
Practice address
9547 HIGHWAY 17 NORTH, MYRTLE BEACH, SC 29572-4039
(843) 449-5283
(843) 497-0880
Mailing address
9547 HIGHWAY 17 NORTH, MYRTLE BEACH, SC 29572-4039
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCF829
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0829NF
—
SC
Enumeration date
05/23/2006
Last updated
03/27/2019
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