Healthcare Provider Details

I. General information

NPI: 1033406301
Provider Name (Legal Business Name): THE REID HOUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 DODD ST
WELLFORD SC
29385-9475
US

IV. Provider business mailing address

117 DODD ST
WELLFORD SC
29385-9475
US

V. Phone/Fax

Practice location:
  • Phone: 864-949-5120
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateSC

VIII. Authorized Official

Name: MRS. KEISHA DANIELS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 864-949-5120