Provider Demographics
NPI:1316713381
Name:FORD MANOR LLC
Entity type:Organization
Organization Name:FORD MANOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEATON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-866-3494
Mailing Address - Street 1:7631 RITTER RD
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-7179
Mailing Address - Country:US
Mailing Address - Phone:843-866-3494
Mailing Address - Fax:843-893-2275
Practice Address - Street 1:7631 RITTER RD
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-7179
Practice Address - Country:US
Practice Address - Phone:843-866-3494
Practice Address - Fax:843-893-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility