# ELI COLLINS FOUNDATION FOR PREMATURE BABIES

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1447902564
- **Authorized official:** MRS. JULIA SELENE TISDALE-SHAW (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (843) 355-5625

## Contact information

- **Practice address:** 137 E MILL ST, KINGSTREE, SC 29556-3427
- **Practice address phone:** (843) 355-5625
- **Practice address fax:** (843) 355-5627
- **Mailing address:** 137 E MILL ST, KINGSTREE, SC 29556-3427
- **Mailing address phone:** (843) 355-5625
- **Mailing address fax:** (843) 355-5627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/20/2022
- **Last updated:** 01/20/2022