Organization
ROUSE COMMUNITY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLENE E ROUSE (OWNER/ ADMINISTRATOR)
(803) 513-6700
Entity
Organization
Contact information
Practice address
8809 WILSON BLVD, COLUMBIA, SC 29203-1817
(803) 513-6700
Mailing address
PO BOX 134, STATE PARK, SC 29147-0134
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
RC0238
SC
310400000X
Assisted Living Facility
Primary
RC0327
SC
310400000X
Assisted Living Facility
RC0328
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RC0327
—
SC
Enumeration date
07/10/2015
Last updated
07/10/2015
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