Organization
MAGNOLIA MENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE REISDORPH APRN (OWNER)
(843) 934-4007
Entity
Organization
Contact information
Practice address
208 E 2ND NORTH ST, SUMMERVILLE, SC 29483-2157
(843) 934-4007
Mailing address
318 POND HILL CT, SUMMERVILLE, SC 29483-5417
(509) 828-8898
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/22/2024
Last updated
10/22/2024
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