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Organization
SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
Active
Organization
SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY ANN KENNEDY (HUMAN SERVICE SPECIALIST 1)
(843) 536-6175
Entity
Organization
Contact information
Practice address
1411 DORDIE CIR, FLORENCE, SC 29506-7368
(843) 536-6175
Mailing address
1411 DORDIE CIR, FLORENCE, SC 29506-7368
(843) 536-6175
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Enumeration date
05/12/2016
Last updated
05/12/2016
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