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Organization
GOOD KIDS INC
Active
Organization
GOOD KIDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT WYLIE (DIRECTOR)
(803) 530-0277
Entity
Organization
Contact information
Practice address
5203 N MAIN ST, COLUMBIA, SC 29203-4520
(803) 216-5397
Mailing address
112 BEAVER CREEK DR, COLUMBIA, SC 29223-7750
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
08/10/2014
Last updated
08/10/2014
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