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General NPI Number Information
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NPI Number | 1366768350
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Entity Type | Organization
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Legal Business Name | ASSURANCE COMMUNITY LONG TERM CARE LLP
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 04/27/2010
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Provider Practice Location Address
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Address Line | 2012 HIGHWAY 160 W
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City | FORT MILL
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State | SC
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Zip | 29708-8401
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Country | US
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Telephone | 803-396-8950
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Fax |
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Provider Business Mailing Address
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Address Line | 2012 HIGHWAY 160 W
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City | FORT MILL
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State | SC
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Zip | 29708-8401
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Country | US
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Telephone | 803-396-8950
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/CEO
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Name | RENEE DIONNE BROWN
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Credential |
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Telephone | 809-396-8950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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