Healthcare Provider Details

I. General information

NPI: 1629668678
Provider Name (Legal Business Name): REACH AND RISE PRESCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2021
Last Update Date: 01/24/2021
Certification Date: 01/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 HELLAMS ST
FOUNTAIN INN SC
29644-9445
US

IV. Provider business mailing address

812 HELLAMS ST
FOUNTAIN INN SC
29644-9445
US

V. Phone/Fax

Practice location:
  • Phone: 864-724-2200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: SILVIA C LANDRUM
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 864-569-8557