Healthcare Provider Details

I. General information

NPI: 1215619333
Provider Name (Legal Business Name): ALZHEIMER'S RESPITE & RESOURCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 WILLIAM HILTON PKWY
HILTON HEAD SC
29926-5206
US

IV. Provider business mailing address

117 WILLIAM HILTON PKWY
HILTON HEAD SC
29926-5206
US

V. Phone/Fax

Practice location:
  • Phone: 843-842-6688
  • Fax: 843-681-5522
Mailing address:
  • Phone: 843-842-6688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name: JILL E BARCIKOWSKI-HORNER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 843-842-6688