Palmetto Ridge Assisted Living & Memory Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

RC1393 Issued in SC

Legal business name

PALMETTO RIDGE ASSISTED LIVING & MEMORY CARE LLC

Practice address

840 Manor Rd
Cheraw, SC 29520-4035

Phone

(843) 537-4197

NPI assigned

Apr 3, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Toni Cooke-Evans

Title

President

Phone

(843) 537-4197

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1225371602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 MANOR RD",
            "address_2": "PO BOX 278",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295204035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 MANOR RD",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295204035",
            "telephone_number": "843-537-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO RIDGE ASSISTED LIVING & MEMORY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-03",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "COOKE-EVANS",
        "authorized_official_first_name": "TONI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-537-4197"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SC",
            "license": "RC1393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC DHEC LICENSE",
            "identifier": "RC1393",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Cheraw, SC
• Providers in Cheraw, SC by specialty
• Assisted Living Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.