Organization
STATEWIDE OUTREACH PROJECT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUENARRL KEITH D.MIN. (EXECUTIVE MINISTER)
(843) 993-5534
Entity
Organization
Contact information
Practice address
396 SAINT PAUL ST, SUITE 1111 CAROLINA OFFICE BUILDING, ORANGEBURG, SC 29115-5465
(888) 992-5534
(866) 408-8142
Mailing address
PO BOX 2863, ORANGEBURG, SC 29116-2863
(866) 408-8142
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/30/2006
Last updated
04/20/2016
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