Healthcare Provider Details

I. General information

NPI: 1033768536
Provider Name (Legal Business Name): SCHOOL ROAD SENIOR LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2019
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 PELZER HWY
EASLEY SC
29642-2941
US

IV. Provider business mailing address

2668 NORTHPARK DR
LAFAYETTE CO
80026-3199
US

V. Phone/Fax

Practice location:
  • Phone: 864-249-1040
  • Fax:
Mailing address:
  • Phone: 303-952-9216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JAMES PATRICK ESTES III
Title or Position: COUNSEL
Credential:
Phone: 503-510-5000