Provider Demographics
NPI:1518927045
Name:RESPITE HOUSE INC
Entity Type:Organization
Organization Name:RESPITE HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:WRIGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:803-254-1248
Mailing Address - Street 1:3600 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-7329
Mailing Address - Country:US
Mailing Address - Phone:803-254-1248
Mailing Address - Fax:803-748-8606
Practice Address - Street 1:3600 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-7329
Practice Address - Country:US
Practice Address - Phone:803-254-1248
Practice Address - Fax:803-748-8606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCADC010261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX0263Medicaid