Healthcare Provider Details

I. General information

NPI: 1407793003
Provider Name (Legal Business Name): BETHEA SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 HOME AVE
DARLINGTON SC
29532-7625
US

IV. Provider business mailing address

157 HOME AVE
DARLINGTON SC
29532-7625
US

V. Phone/Fax

Practice location:
  • Phone: 843-393-2867
  • Fax:
Mailing address:
  • Phone: 843-393-2867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA B MATHENY
Title or Position: AUTHORIZED SIGNATORY
Credential:
Phone: 423-883-7920