Organization
POTTER'S HOUSE PALMETTO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY A. SPATEHOLTS M.ED. (CHIEF OFFICER RM & COMPLIANCE)
(843) 200-4268
Entity
Organization
Contact information
Practice address
104 E BERRY ST, LINCOLNVILLE, SC 29485-7204
(843) 200-4268
Mailing address
2414 CLEMENT'S FERRY RD., CHARLESTON, SC 29429
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/09/2016
Last updated
03/09/2016
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