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Organization
PEE DEE MENTAL HEALTH
Active
Organization
PEE DEE MENTAL HEALTH
Active
Parent organization
SOTH CAROLINA DEPARTMENT OF MENTAL HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOTH CAROLINA DEPARTMENT OF MENTAL HEALTH
Authorized official
ROBIN WINDHAM (AR SUPERVISOR)
(843) 629-2483
Entity
Organization
Contact information
Practice address
675 N MATTHEWS RD, LAKE CITY, SC 29560-7027
(843) 394-7600
Mailing address
4 JESSAMINE ST, ANDREWS, SC 29510-4414
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376241
—
SC
Enumeration date
03/14/2014
Last updated
03/14/2014
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