Provider Demographics
NPI:1689858367
Name:HARMONY RESIDENTIAL CARE CENTER, LLC
Entity Type:Organization
Organization Name:HARMONY RESIDENTIAL CARE CENTER, LLC
Other - Org Name:WARE SHOALS ASSISTED LIVING FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:OBIAJULU
Authorized Official - Middle Name:E
Authorized Official - Last Name:MELEKWE
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:864-488-2006
Mailing Address - Street 1:10 N GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WARE SHOALS
Mailing Address - State:SC
Mailing Address - Zip Code:29692-1239
Mailing Address - Country:US
Mailing Address - Phone:864-456-7127
Mailing Address - Fax:864-456-7401
Practice Address - Street 1:10 N GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:WARE SHOALS
Practice Address - State:SC
Practice Address - Zip Code:29692-1239
Practice Address - Country:US
Practice Address - Phone:864-456-7127
Practice Address - Fax:864-456-7401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARMONY RESIDENTIAL CARE CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCCRC1457310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCRC1457OtherDHEC