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General NPI Number Information
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NPI Number | 1073260048
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Entity Type | Organization
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Legal Business Name | SOUTHLAND HEALTH CARE CENTER INC
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Dates
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Enumeration Date | 03/09/2022
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 722 S DARGAN ST
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City | FLORENCE
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State | SC
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Zip | 29506-2559
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Country | US
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Telephone | 843-669-4403
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Fax |
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Provider Business Mailing Address
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Address Line | 722 S DARGAN ST
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City | FLORENCE
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State | SC
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Zip | 29506-2559
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHARLES COMMANDER
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Credential |
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Telephone | 843-669-4403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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