Organization
SOCIAL CHANGE INITIATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GASKIN (PRESIDENT/CEO)
(864) 388-4102
Entity
Organization
Contact information
Practice address
1402 C HWY 72 WEST, GREENWOOD, SC 29649
(864) 388-4102
Mailing address
1402 C HWY 72 WEST, GREENWOOD, SC 29649
(864) 388-4102
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/18/2015
Last updated
06/18/2015
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