OrganizationActive
Lake Wylie
NPI 1720200884 · Assisted Living Facility · Lake Wylie, SC
Lake Wylie is a Assisted Living Facility organization in Lake Wylie, SC (NPI 1720200884).
Provider details
- NPI number
- 1720200884
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Jon Harder, President(503) 486-8697
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4877 Charlotte Highway
Lake Wylie, SC 29710
Phone: (803) 831-9900
Street-level locationGet directions
Mailing address
Po Box 3006
Salem, OR 97302
Registry dates
- Enumerated
- 2007-05-02
- Last updated
- 2020-08-22
Frequently asked questions
- What is Lake Wylie's NPI number?
- Lake Wylie's National Provider Identifier (NPI) is 1720200884, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Wylie?
- Lake Wylie is classified in the NPPES registry as Assisted Living Facility (Nursing & Custodial Care Facilities).
- Where is Lake Wylie located?
- Lake Wylie's practice location on file with NPPES is 4877 Charlotte Highway, Lake Wylie, SC 29710.
- What is Lake Wylie's phone number?
- The practice phone number listed in the NPPES registry for Lake Wylie is (803) 831-9900.
- Who is the authorized official for Lake Wylie?
- The authorized official listed on Lake Wylie's NPPES record is Jon Harder, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Wylie's NPI active?
- Yes — Lake Wylie's NPI (1720200884) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.