South Boston Manor, LLC
NPI #1740277359 in South Boston, Virginia
Provider Information
- NPI Number
- 1740277359
- Entity Type
- Organization
- Organization Name
- South Boston Manor, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Sep 29, 2005
- Last Updated
- Nov 2, 2011
Practice Location
- Address
- 406 OAK LN
- City
- South Boston
- State
- Virginia
- ZIP Code
- 24592-1634
- Phone
- (434) 572-2925
Authorized Official
- Name
- MR. W. STEWART SWAIN
- Title
- TREASURER
- Phone
- (843) 902-4582
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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