Provider Demographics
NPI:1356426738
Name:SAVANNAH GRACE HALLS LP
Entity type:Organization
Organization Name:SAVANNAH GRACE HALLS LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:E.
Authorized Official - Middle Name:DURANT
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-232-5487
Mailing Address - Street 1:300 N GREENE STREET
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401
Mailing Address - Country:US
Mailing Address - Phone:336-232-1900
Mailing Address - Fax:336-232-1901
Practice Address - Street 1:1010 LAKE HUNTER CIRCLE
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5417
Practice Address - Country:US
Practice Address - Phone:843-388-2030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCNCF-774314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC425367Medicare Oscar/Certification