Provider Demographics
NPI:1245256858
Name:LAUREL HILL LIVING CENTER, LLC
Entity type:Organization
Organization Name:LAUREL HILL LIVING CENTER, LLC
Other - Org Name:
Other - Org Type:
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 1:716 E CEDAR ROCK ST
Practice Address - Street 2:
Practice Address - City:PICKENS
Practice Address - State:SC
Practice Address - Zip Code:29671-2324
Practice Address - Country:US
Practice Address - Phone:864-878-4739
Practice Address - Fax:864-878-5693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCNCF-910314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0609 NHMedicaid
SC0609 NHMedicaid
SC42-5084Medicare PIN