Organization
THE BLAKE RCF
Active
Other names
THE BLAKE RCF
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NOVELLA Y JACKSON (CEO)
(803) 262-8387
Entity
Organization
Contact information
Practice address
1219 JASPER ST, ORANGEBURG, SC 29115-3570
(803) 244-0373
(803) 244-0372
Mailing address
1219 JASPER ST, ORANGEBURG, SC 29115-3570
(803) 244-0373
(803) 244-0372
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
SC
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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