Provider Demographics
NPI:1851789416
Name:CARRIAGE HOUSE SENIOR LIVING OF SUMTER, INC.
Entity Type:Organization
Organization Name:CARRIAGE HOUSE SENIOR LIVING OF SUMTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:F
Authorized Official - Last Name:BIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-920-1180
Mailing Address - Street 1:201 S MCPHERSON CHURCH RD
Mailing Address - Street 2:SUITE 226
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4974
Mailing Address - Country:US
Mailing Address - Phone:910-920-1180
Mailing Address - Fax:910-920-1545
Practice Address - Street 1:431 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4232
Practice Address - Country:US
Practice Address - Phone:803-773-0965
Practice Address - Fax:910-920-1545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home