Regina Rose Life Center

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

REGINA ROSE LIFE CENTER

Practice address

100 Crowfield Blvd
Goose Creek, SC 29445-5337

Phone

(843) 409-8520

NPI assigned

Jun 23, 2025

Last updated

Jun 23, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shane Reid

Title

Ceo

Phone

(843) 409-8520

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1366339327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROWFIELD BLVD",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455337",
            "telephone_number": "843-409-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CROWFIELD BLVD",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455337",
            "telephone_number": "843-409-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGINA ROSE LIFE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-409-8520"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Goose Creek, SC
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.