MARANATHA MANOR OF SPARTANBURG, INC
Assisted Living Facility
Spartanburg, South Carolina
Provider NPI: 1962480186
Organization Information:Organization Name: MARANATHA MANOR OF SPARTANBURG, INC
Practice Location:
2902 E MAIN STREET EXT SPARTANBURG, SC 29307 US
Tel: 864-579-0086 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
2902 E MAIN STREET EXT SPARTANBURG, SC 29307 US
Tel: 864-579-0086 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | SC | CRC1235 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
RC1235 | SC | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin