Organization
BRK PSYCHIATRIC MENTAL HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERNICE KENNEDY APRN (PSYCHIATRIC MENTAL HEALTH -CNS)
(803) 353-2082
Entity
Organization
Contact information
Practice address
1156 OLD MCGRAW RD, EASTOVER, SC 29044-9116
(803) 353-2082
(803) 353-2082
Mailing address
PO BOX 90899, COLUMBIA, SC 29290-1889
(803) 353-2082
(803) 353-2082
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3264
—
SC
Enumeration date
07/20/2021
Last updated
07/20/2021
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