Organization
GREENWOOD COUNTY
Active
Other names
LEGACY
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TETEASA MICHELLE SHAW (DIRECTOR)
(864) 942-8766
Entity
Organization
Contact information
Practice address
528 MONUMENT ST STE 105, GREENWOOD, SC 29646-2634
(864) 942-8766
Mailing address
PO BOX 3312, GREENWOOD, SC 29648-3312
(864) 942-8766
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
07/19/2007
Last updated
07/19/2007
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