Provider Demographics
NPI:1164815312
Name:REHAB CENTER OF CHERAW LLC
Entity Type:Organization
Organization Name:REHAB CENTER OF CHERAW LLC
Other - Org Name:REHAB CENTER OF CHERAW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-537-2060
Mailing Address - Street 1:1150 STATE RD
Mailing Address - Street 2:
Mailing Address - City:CHERAW
Mailing Address - State:SC
Mailing Address - Zip Code:29520-2048
Mailing Address - Country:US
Mailing Address - Phone:843-537-2060
Mailing Address - Fax:843-537-3676
Practice Address - Street 1:1150 STATE RD
Practice Address - Street 2:
Practice Address - City:CHERAW
Practice Address - State:SC
Practice Address - Zip Code:29520-2048
Practice Address - Country:US
Practice Address - Phone:843-537-2060
Practice Address - Fax:843-537-3676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNF1058Medicaid
SCNF1058Medicaid