| Organization Name: | OAKRIDGE COMMUNITY CARE HOME |
| NPI Number: | 1043655319 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DARRYL ALAN MAST (ADMINISTRATOR) |
| Mailing Address: | 2470 Old Mill Rd Inman |
| State: | SC US |
| Postal Code: | 293499276 |
| Phone Number: | 8644726979 |
| Fax Number: | |
| NPI Enumeration Date: | 05/01/2013 |
| NPI Last Update Date: | 05/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1500X |
| License Number: | CRC-0241 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |