OrganizationActive
Dhec
NPI 1023558905 · Nursing Facility/Intermediate Care Facility · Mullins, SC
Provider details
- NPI number
- 1023558905
- Entity type
- Organization
- Primary specialty
- Nursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Leslie Jackson, RN(843) 992-9132
- License
- 235692 (SC)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
319 Stephen Ct
Mullins, SC 29574-4223
Phone: (843) 992-9132
Approximate (ZIP-level) locationGet directions
Mailing address
319 Stephen Ct
Mullins, SC 29574-4223
Registry dates
- Enumerated
- 2017-02-27
- Last updated
- 2017-02-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.