Provider Demographics
NPI:1851308456
Name:SAVANNAH HEIGHTS LIVING CENTER, LLC
Entity Type:Organization
Organization Name:SAVANNAH HEIGHTS LIVING CENTER, LLC
Other - Org Name:MCCORMICK HEALTH CARE CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP & CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:SWIFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-269-3725
Mailing Address - Street 1:101 GRACE DR
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-9088
Mailing Address - Country:US
Mailing Address - Phone:864-269-3725
Mailing Address - Fax:864-295-3383
Practice Address - Street 1:1 HOLIDAY RD
Practice Address - Street 2:
Practice Address - City:MCCORMICK
Practice Address - State:SC
Practice Address - Zip Code:29835
Practice Address - Country:US
Practice Address - Phone:864-391-2390
Practice Address - Fax:864-391-2397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCNCF-510314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0510NHMedicaid
SC42-5171Medicare PIN
SC425171Medicare ID - Type UnspecifiedMEDICARE PROVIDER #