MEDICARE: CONNECTION PLACE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251E00000X	Home Health Agency
3	251S00000X	Community/Behavioral Health Agency
4	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1639011422
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECTION PLACE

Provider Business Mailing Address
First Line	:	PO BOX 1813
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29202-1813
Country	:	US
Telephone Number	:	888-739-1107
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 SAINT ANDREWS RD APT 502
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29210-5937
Country	:	US
Telephone Number	:	888-739-1107
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	TANAKA CHANDLER
Credential	:
Telephone Number	:	888-739-1107

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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