REFLECTIONS AT CAROLINA FOREST, INC.
NPI 1770886186
Assisted Living Facility in Myrtle Beach, SC

NPI Status: Active since December 08, 2010

Contact Information

219 MIDDLEBURG DR
MYRTLE BEACH, SC
ZIP 29579
Phone: (843) 903-0700
Fax: (843) 903-0714

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 42D1086539
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 07-14-2026

About REFLECTIONS AT CAROLINA FOREST, INC.

This page provides the complete NPI Profile along with additional information for Reflections At Carolina Forest, Inc., a provider established in Myrtle Beach, South Carolina operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1770886186 assigned on December 2010. The practitioner's primary taxonomy code is 310400000X with license number CRC-1456 (SC). The provider is registered as an organization and their NPI record was last updated 15 years ago. The authorized official of this NPI record is Mr. Wallace Dekalb Clardy Jr. Crcfa (President/ceo)

NPI
1770886186
Provider Name
REFLECTIONS AT CAROLINA FOREST, INC.
Entity Type
Organization
Location Address
219 MIDDLEBURG DR MYRTLE BEACH, SC 29579
Location Phone
(843) 903-0700
Location Fax
(843) 903-0714
Mailing Address
219 MIDDLEBURG DR MYRTLE BEACH, SC 29579
Mailing Phone
(843) 903-0700
Mailing Fax
(843) 903-0714
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-08-2010
Last Update Date
12-08-2010
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
CRC-1456
License State
SC
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. WALLACE DEKALB CLARDY JR. CRCFA

Authorized Official Title
PRESIDENT/CEO
Authorized Official Phone
(843) 903-0700

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
42D1086539
Facility Type
Assisted Living Facility
Certificate Effective Date
July 15, 2024
Certificate Expiration Date
July 14, 2026
Laboratory Director
WALLACE D. CLARDY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Reflections At Carolina Forest, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1770886186
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2714016812116
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 4 + 0 + 1 + 6 + 8 + 1 + 2 + 1 + 1 + 6 + 24 = 64
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 64 = 66

The NPI number 1770886186 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1770886186, enumerated in the NPI registry as an "organization" on December 08, 2010

The provider is located at 219 Middleburg Dr Myrtle Beach, Sc 29579 and the phone number is (843) 903-0700

This medical organization specializes in Assisted Living Facility with taxonomy code 310400000X

The provider's CLIA number is 42D1086539 for a "assisted living facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on December 08, 2010. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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