Healthcare Provider Details

I. General information

NPI: 1336398148
Provider Name (Legal Business Name): THERE'S ROOM, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 TAYLOR STREET SUITE E
COLUMBIA SC
29204
US

IV. Provider business mailing address

PO BOX 2741
COLUMBIA SC
29202-2741
US

V. Phone/Fax

Practice location:
  • Phone: 803-708-4712
  • Fax: 803-708-4718
Mailing address:
  • Phone: 803-708-4712
  • Fax: 803-708-4718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License NumberSR1009849001CPA
License Number StateSC

VIII. Authorized Official

Name: MRS. JACQUELYN GADSDEN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 803-708-4712