# COVERED BY CHUKWU

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

## Provider details

- **NPI number:** 1295618106
- **Authorized official:** SHARAI ROSE MONTGOMERY (OUTREACH AND EQUITY DIRECTOR)
- **Authorized official phone:** (843) 591-4546

## Contact information

- **Practice address:** 3535 STARLING RD, MULLINS, SC 29574-7330
- **Practice address phone:** (843) 591-4546
- **Mailing address:** 3535 STARLING RD, MULLINS, SC 29574-7330
- **Mailing address phone:** (843) 591-4546

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP1600X | Pastoral Counselor | — | NULL | Yes |
| 101YP1600X | Pastoral Counselor | — | — | Yes |
| 251B00000X | Case Management Agency | — | NULL | — |
| 282J00000X | Religious Nonmedical Health Care Institution | — | NULL | — |
| 374K00000X | Religious Nonmedical Practitioner | — | NULL | — |
| 374K00000X | Religious Nonmedical Practitioner | — | — | — |
| 374T00000X | Religious Nonmedical Nursing Personnel | — | NULL | — |
| 374T00000X | Religious Nonmedical Nursing Personnel | — | — | — |

## Other

- **Enumeration date:** 07/28/2025
- **Last updated:** 08/17/2025