Provider Demographics
NPI:1922626837
Name:BROOKSTONE TERRACE OF WOODRUFF, LLC
Entity Type:Organization
Organization Name:BROOKSTONE TERRACE OF WOODRUFF, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DEL-TORO
Authorized Official - Suffix:
Authorized Official - Credentials:SCCRCF ADMINISTRATOR
Authorized Official - Phone:864-476-9100
Mailing Address - Street 1:80 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WOODRUFF
Mailing Address - State:SC
Mailing Address - Zip Code:29388-8781
Mailing Address - Country:US
Mailing Address - Phone:864-476-9100
Mailing Address - Fax:864-476-9202
Practice Address - Street 1:80 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WOODRUFF
Practice Address - State:SC
Practice Address - Zip Code:29388-8781
Practice Address - Country:US
Practice Address - Phone:864-476-9100
Practice Address - Fax:864-476-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility