Organization
MARY'S ANGELS INDEPENDENT LIVING FOR YOUNG WOMEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUANTIA GREEN (PRESIDENT/CEO)
(843) 382-5285
Entity
Organization
Contact information
Practice address
29 SUNFLOWER DR, CADES, SC 29518-3312
(843) 382-5285
(843) 382-7280
Mailing address
29 SUNFLOWER DR, CADES, SC 29518-3312
(843) 382-5285
(843) 382-7280
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/06/2014
Last updated
08/06/2014
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