Provider Demographics
NPI:1780060111
Name:HEALTH & HEALING REHAB SERVICES
Entity type:Organization
Organization Name:HEALTH & HEALING REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:SR
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:803-665-6527
Mailing Address - Street 1:2 BRADFORD RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-7136
Mailing Address - Country:US
Mailing Address - Phone:803-665-6527
Mailing Address - Fax:803-699-2270
Practice Address - Street 1:2 BRADFORD RIDGE CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-7136
Practice Address - Country:US
Practice Address - Phone:803-665-6527
Practice Address - Fax:803-699-2270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2345225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty