Organization
PHC SUPPORTIVE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GEROTHIA MCCULLOUGH (OWNER)
(864) 478-8688
Entity
Organization
Contact information
Practice address
300 W BUTLER RD, SUITE B, MAULDIN, SC 29662-2585
(864) 478-8688
Mailing address
300 W BUTLER RD, SUITE B, MAULDIN, SC 29662-2585
(864) 478-8688
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5544
SC
Other
Enumeration date
02/23/2015
Last updated
02/23/2015
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