Maranatha Manor of Spartanburg, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

CRC1235 Issued in SC

Legal business name

MARANATHA MANOR OF SPARTANBURG, INC

Practice address

2902 E Main Street Ext
Spartanburg, SC 29307-1252

Phone

(864) 579-0086

Fax

(864) 579-0466

NPI assigned

Jan 6, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Sandra M West

Title

Office Manager

Phone

(864) 579-0086

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962480186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2902 E MAIN STREET EXT",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071252",
            "telephone_number": "864-579-0086",
            "fax_number": "864-579-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 E MAIN STREET EXT",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071252",
            "telephone_number": "864-579-0086",
            "fax_number": "864-579-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARANATHA MANOR OF SPARTANBURG, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "864-579-0086",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SC",
            "license": "CRC1235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RC1235",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Nicholas Mann, NP-C
• Patricia Manning
• Vanessa A Manotas, BS
• Kristin M Manske, DPT
• Elizabeth Denise Manthe
• Tina Marchese, RN
• Christopher Marchewka, LMSW
• Lou Bernice Marcum, FNP-BC
• Megan Brittany Maree, PHARMD
• Donna Mariano

• Assisted Living Facility in Spartanburg, SC
• Providers in Spartanburg, 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 Aug 22, 2020; 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.