Healthcare Provider Details

I. General information

NPI: 1336467083
Provider Name (Legal Business Name): REST ASSURED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2010
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 RICE BENT WAY SUITE 8
COLUMBIA SC
29229-6849
US

IV. Provider business mailing address

101 RICE BENT WAY SUITE 8
COLUMBIA SC
29229-6849
US

V. Phone/Fax

Practice location:
  • Phone: 803-865-8113
  • Fax:
Mailing address:
  • Phone: 803-865-8113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number20102927728429
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: REATHA JOHNSON
Title or Position: DON
Credential: RN
Phone: 803-865-8113