- Enrollment id
- O20200129002300
- Enrollment state
- SC
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1881150928
- Multiple npi flag
- N
- Ccn
- 425368
- Associate id
- 7012343692
- Organization name
- JOHNS ISLAND POST ACUTE LLC
- Doing business as name
- JOHNS ISLAND POST ACUTE
- Incorporation date
- 2019-02-13
- Incorporation state
- SC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- JOHNS ISLAND POST ACUTE
- Affiliation entity name
- PACS GROUP
- Affiliation entity id
- 690
- Address line 1
- 3647 MAYBANK HWY
- City
- JOHNS ISLAND
- State
- SC
- Zip code
- 294554825