Organization
LANTERN RESIDENCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZACHARY MITCHELL CPSS (OWNER/CLIENT LIASON)
(843) 834-0448
Entity
Organization
Contact information
Practice address
3043 MATIPAN AVE, N CHARLESTON, SC 29405-8206
(843) 806-1085
Mailing address
180 SPRING ST, CHARLESTON, SC 29403-5219
(843) 670-3358
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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