The Blake RCF

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

THE BLAKE RCF

Doing business as

The Blake RCF

Practice address

1219 Jasper St
Orangeburg, SC 29115-3570

Phone

(803) 244-0373

Fax

(803) 244-0372

NPI assigned

Jul 12, 2018

Last updated

Jul 12, 2018By 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

Ms. Novella Y Jackson

Title

Ceo

Phone

(803) 262-8387

Specialties & licenses 1

Addresses

Other names 1

• THE BLAKE RCF Doing business as

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531353600000",
    "number": "1730665761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 JASPER ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291153570",
            "telephone_number": "803-244-0373",
            "fax_number": "803-244-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 JASPER ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291153570",
            "telephone_number": "803-244-0373",
            "fax_number": "803-244-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BLAKE RCF",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "NOVELLA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-262-8387",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE BLAKE RCF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility (Mental Illness) in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Assisted Living Facility (Mental Illness) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.