Healthcare Provider Details

I. General information

NPI: 1851187769
Provider Name (Legal Business Name): GABLES ON PELHAM RETIREMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 PELHAM RD
GREENVILLE SC
29615-3600
US

IV. Provider business mailing address

3530 TORINGDON WAY STE 204
CHARLOTTE NC
28277-3436
US

V. Phone/Fax

Practice location:
  • Phone: 864-286-6600
  • Fax: 704-246-1621
Mailing address:
  • Phone: 704-246-1620
  • Fax: 704-246-1621

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: BENJAMIN THOMPSON
Title or Position: CEO
Credential:
Phone: 704-815-7341