Organization
DIVINE NURSE CONSULTANT
Active
Other names
DIVINE MANOR ASSISTED LIVING
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLIFFORD C AFAM (DIRECTOR)
(980) 622-8530
Entity
Organization
Contact information
Practice address
2210 OAK POND RD, ROCK HILL, SC 29730-7958
(803) 329-4494
(803) 329-5902
Mailing address
2210 OAK POND RD, ROCK HILL, SC 29730-7958
(803) 329-4494
(803) 329-5902
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
RC1361
SC
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
RC1361
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RC1361
FACILITY NUMBER
SC
Enumeration date
07/09/2015
Last updated
01/03/2020
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