# CHANNEL THE BEACON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205260304
- **Authorized official:** JOHNETTE S SIMMONS BS, MBA, DHA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (843) 330-1522

## Contact information

- **Practice address:** 6650 RIVERS AVE, SUITE 1408, NORTH CHARLESTON, SC 29406-4809
- **Practice address phone:** (843) 576-1408
- **Practice address fax:** (843) 278-9275
- **Mailing address:** PO BOX 41294, NORTH CHARLESTON, SC 29423-1294
- **Mailing address phone:** (843) 330-1522
- **Mailing address fax:** (843) 278-9275

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | SC | Yes |
| 251V00000X | Voluntary or Charitable Agency | — | SC | — |

## Other

- **Enumeration date:** 08/26/2013
- **Last updated:** 09/05/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | CM1007 | — | SC |