Organization
KOKO'S HOUSE OF GEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHMEAKA ROCHELLE CAMPBELL (OWNER)
(843) 530-1643
Entity
Organization
Contact information
Practice address
527 ORANGEBURG RD APT B8, SUMMERVILLE, SC 29483-8981
(843) 530-1643
Mailing address
527 ORANGEBURG RD APT B8, SUMMERVILLE, SC 29483-8981
(843) 530-1643
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
311ZA0620X
Adult Care Home Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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