Healthcare Provider Details
I. General information
NPI: 1376091843
Provider Name (Legal Business Name): BRUSHY CREEK REHABILITATION AND HEALTHCARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/14/2016
Last Update Date: 12/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 COTTAGE CREEK CIR
GREER SC
29650-2438
US
IV. Provider business mailing address
101 COTTAGE CREEK CIR
GREER SC
29650-2438
US
V. Phone/Fax
- Phone: 864-688-3800
- Fax: 864-801-1047
- Phone: 864-688-3800
- Fax: 864-801-1047
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHELLE
D
MEER
Title or Position: VICE PRESIDENT & SECRETARY
Credential:
Phone: 629-626-0000