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General NPI Number Information
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NPI Number | 1548868417
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Entity Type | Organization
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Legal Business Name | WILLIAMS COMMUNITY CARE HOME
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Dates
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Enumeration Date | 10/13/2020
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 7705 RICHARD ST
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City | COLUMBIA
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State | SC
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Zip | 29209-3733
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Country | US
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Telephone | 803-783-1223
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Fax | 803-783-3044
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Provider Business Mailing Address
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Address Line | 8435 MONTICELLO RD
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City | COLUMBIA
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State | SC
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Zip | 29203-9473
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Country | US
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Telephone | 803-730-4764
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Fax | 803-783-3044
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Authorized Official
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Title or Position | ADMINISTRATOR /OWNER
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Name | CHARLES WILLIAMS
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Credential |
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Telephone | 803-730-4764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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