Healthcare Provider Details

I. General information

NPI: 1548731045
Provider Name (Legal Business Name): GREENVILLE POST ACUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2018
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 RUTHERFORD RD
GREENVILLE SC
29609-4640
US

IV. Provider business mailing address

262 N UNIVERSITY AVE
FARMINGTON UT
84025-2975
US

V. Phone/Fax

Practice location:
  • Phone: 864-232-2442
  • Fax:
Mailing address:
  • Phone: 385-518-1814
  • Fax: 801-447-9797

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: JOHN MITCHELL
Title or Position: SECRETARY
Credential:
Phone: 385-988-3319