Healthcare Provider Details

I. General information

NPI: 1124231337
Provider Name (Legal Business Name): REID HOUSE OF CHRISTIAN SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 SAINT PHILIP ST
CHARLESTON SC
29403-5457
US

IV. Provider business mailing address

PO BOX 22132
CHARLESTON SC
29413-2132
US

V. Phone/Fax

Practice location:
  • Phone: 843-723-7138
  • Fax: 843-722-8797
Mailing address:
  • Phone: 843-723-7138
  • Fax: 843-722-8797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberADC-025
License Number StateSC

VIII. Authorized Official

Name: MS. DOLORES S. GREENE
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW
Phone: 843-723-7138