Wide Awake Center and Community Outreach

NPI #1053293225 in Ravenel, South Carolina

Provider Information

NPI Number: 1053293225
Entity Type: Organization
Organization Name: Wide Awake Center and Community Outreach
Primary Specialty: Technician - Personal Care Attendant
Enumeration Date: Jul 21, 2025
Last Updated: Jul 21, 2025

Practice Location

Address: 6005 CENTER STATION CT
City: Ravenel
State: South Carolina
ZIP Code: 29470-5681
Phone: (843) 475-5605

Authorized Official

Name: CASSANDRA SMITH
Title: DIRECTOR
Phone: (843) 475-5605

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X
Contractor	171W00000X
Contractor - Home Modifications — Home Modifications	171WH0202X
Meals	174200000X
Health Educator	174H00000X
Lodging	177F00000X
Case Management	251B00000X
Community/Behavioral Health	251S00000X
Voluntary or Charitable	251V00000X
In Home Supportive Care	253Z00000X
Non-emergency Medical Transport (VAN)	343900000X
Home Health Aide	374U00000X
Homemaker	376J00000X
Respite Care	385H00000X
Technician - Personal Care Attendant — Personal Care Attendant	3747P1801X	Primary

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