Organization
COMMUNITY WELLNESS AND REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRANCE JOSEPH SKIDMORE LCSW (DIRECTOR, LCSW)
(337) 853-2292
Entity
Organization
Contact information
Practice address
25911 SANDY CREEK CT, GULFPORT, MS 39503-7014
(337) 853-2292
Mailing address
25911 SANDY CREEK CT, GULFPORT, MS 39503-7014
(337) 853-2292
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/16/2024
Last updated
12/18/2024
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