Provider Demographics
NPI:1093967218
Name:CASCADES NURSING, LLC
Entity Type:Organization
Organization Name:CASCADES NURSING, LLC
Other - Org Name:BANYAN GREENVILLE NURSING SERVICES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:O
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:704-246-1616
Mailing Address - Street 1:10 FOUNTAINVIEW TERRACE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-4033
Mailing Address - Country:US
Mailing Address - Phone:864-528-5502
Mailing Address - Fax:864-528-5550
Practice Address - Street 1:10 FOUNTAINVIEW TERRACE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-4033
Practice Address - Country:US
Practice Address - Phone:864-528-5502
Practice Address - Fax:864-528-5550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X, 311500000X, 314000000X
SCCRC-1490310400000X
SCNCF-0956314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
425392Medicare Oscar/Certification