Organization
WIDE AWAKE CENTER AND COMMUNITY OUTREACH
Active
Organization
WIDE AWAKE CENTER AND COMMUNITY OUTREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA SMITH (DIRECTOR)
(843) 475-5605
Entity
Organization
Contact information
Practice address
6005 CENTER STATION CT, RAVENEL, SC 29470-5681
(843) 475-5605
Mailing address
1640 BERTHA MARIE LN, WADMALAW ISLAND, SC 29487-7188
(843) 475-5605
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171W00000X
Contractor
—
—
171WH0202X
Home Modifications Contractor
—
—
174200000X
Meals Provider
—
—
174H00000X
Health Educator
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
07/21/2025
Last updated
07/21/2025
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