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Contact Information

BRIGHTWATER RETIREMENT, LLC
101 BRIGHTWATER DR
MYRTLE BEACH, SC29579-8268
 Phone: 843-903-8300
 Fax: 843-236-1644
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Assisted Living Facility

310400000X
 

Home Health

251E00000X A4[11] Home Health Agency
Indicates primary specialty

NPI Profile & details for BRIGHTWATER RETIREMENT, LLC

NPI Number 1407090434
LBN Legal business name BRIGHTWATER RETIREMENT, LLC
Authorized official GARY VENTOLA - (SR. VP OF ADMINISTRATION)
Entity Organization
Organization subpart 1 No
Enumeration date 04/21/2009
Last updated 01/14/2016 - About 10 years ago
Identifiers
SC License # CRC-1489
SC License # NCF-0955
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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