# ROUSE COMMUNITY CARE HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740664598
- **Authorized official:** MRS. CHARLENE E ROUSE (OWNER/ ADMINISTRATOR)
- **Authorized official phone:** (803) 513-6700

## Contact information

- **Practice address:** 8809 WILSON BLVD, COLUMBIA, SC 29203-1817
- **Practice address phone:** (803) 513-6700
- **Mailing address:** PO BOX 134, STATE PARK, SC 29147-0134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | RC0238 | SC | — |
| 310400000X | Assisted Living Facility | RC0327 | SC | Yes |
| 310400000X | Assisted Living Facility | RC0328 | SC | — |

## Other

- **Enumeration date:** 07/10/2015
- **Last updated:** 07/10/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | RC0327 | — | SC |