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General NPI Number Information
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NPI Number | 1386731313
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Entity Type | Organization
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Legal Business Name | VALLEY FALLS TERRACE INC
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 400 LOCUST GRV
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City | SPARTANBURG
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State | SC
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Zip | 29303-4831
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Country | US
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Telephone | 864-503-0377
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5419
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City | SPARTANBURG
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State | SC
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Zip | 29304-5419
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Country | US
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Telephone | 864-582-8983
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Fax |
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Authorized Official
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Title or Position | VP FINANCE
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Name | MYRIA POLYDOROU
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Credential | CPA
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Telephone | 864-582-8983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | NCF495
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License Number State | SC
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