Herman L. Anderson Inc,

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

CRC-1506 Issued in SC

Legal business name

HERMAN L. ANDERSON INC,

Doing business as

Anderson Oaks Assisted Livinge

Practice address

997 Highway 90
Conway, SC 29526-7520

Phone

(843) 347-9280

NPI assigned

Jun 19, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Janice C Flecknoe, ADMINISTRATOR

Title

Administrator

Phone

(843) 347-9280

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Anderson Oaks Assisted Livinge Doing business as

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1497169254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 HIGHWAY 90",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295267520",
            "telephone_number": "843-347-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 HIGHWAY 90",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295267520",
            "telephone_number": "843-347-9280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERMAN L. ANDERSON INC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "FLECKNOE",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "843-347-9280",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SC",
            "license": "CRC-1506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY LICENSE",
            "identifier": "CRC-1506",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anderson Oaks Assisted Livinge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gregory D Henderson, CRNA
• Rebecca A Henkle
• Herbert Thomas Henry
• Melissa Ann Henry
• Trina Marie Henry, OTR/L
• Jose J. Hernandez, MD
• Suzanne Marie Heroux, RN MA
• Trevor James Hess, MA, ATC, CSCS
• HHC South Carolina Inc (Lighthouse Behavioral Health Hospital)
• Tomika Hickson

• Assisted Living Facility in Conway, SC
• Providers in Conway, 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 Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.