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General NPI Number Information
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NPI Number | 1124231337
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Entity Type | Organization
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Legal Business Name | REID HOUSE OF CHRISTIAN SERVICE
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 165 SAINT PHILIP ST
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City | CHARLESTON
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State | SC
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Zip | 29403-5457
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Country | US
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Telephone | 843-723-7138
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Fax | 843-722-8797
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Provider Business Mailing Address
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Address Line | PO BOX 22132
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City | CHARLESTON
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State | SC
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Zip | 29413-2132
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Country | US
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Telephone | 843-723-7138
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Fax | 843-722-8797
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. DOLORES S. GREENE
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Credential | MSW
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Telephone | 843-723-7138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | ADC-025
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License Number State | SC
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