Organization
SHOOTING STARS EARLY INTERVENTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA NELSON (OWNER)
(803) 420-8492
Entity
Organization
Contact information
Practice address
1860 SPRINGVALE RD, LUGOFF, SC 29078-9788
(803) 420-8492
Mailing address
1860 SPRINGVALE RD, LUGOFF, SC 29078-9788
(803) 420-8492
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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