Organization
SOUTHERN SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE ANN GRANT MSW, LCSWA (QMTD)
(252) 702-9176
Entity
Organization
Contact information
Practice address
514 2ND LOOP RD, SUITE C, FLORENCE, SC 29505-2848
(843) 665-5181
(843) 665-5189
Mailing address
514 2ND LOOP RD, SUITE C, FLORENCE, SC 29505-2848
(843) 665-5181
(843) 665-5189
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/12/2012
Last updated
12/12/2012
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