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General NPI Number Information
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NPI Number | 1922626837
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Entity Type | Organization
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Legal Business Name | BROOKSTONE TERRACE OF WOODRUFF, LLC
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Dates
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Enumeration Date | 07/07/2020
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 80 MEDICAL CENTER DR
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City | WOODRUFF
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State | SC
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Zip | 29388-8781
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Country | US
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Telephone | 864-476-9100
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Fax | 864-476-9202
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Provider Business Mailing Address
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Address Line | 80 MEDICAL CENTER DR
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City | WOODRUFF
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State | SC
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Zip | 29388-8781
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Country | US
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Telephone | 864-476-9100
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Fax | 864-476-9202
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARIANNA L DEL-TORO
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Credential | SCCRCF ADMINISTRATOR
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Telephone | 864-476-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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