Organization
BROTHER2BROTHER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEE M COLES MBA (EXECUTIVE DIRECTOR)
(803) 699-1050
Entity
Organization
Contact information
Practice address
3031 SCOTSMAN RD, COLUMBIA, SC 29223-1812
(803) 699-1050
(803) 699-1067
Mailing address
3031 SCOTSMAN RD, COLUMBIA, SC 29223-1812
(803) 699-1050
(803) 699-1067
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/20/2010
Last updated
07/24/2014
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