Organization
GRACEFUL LIVING BEHAVIORAL SUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MODUPE SARUMI PHARMD, MPH (EXECUTIVE DIRECTOR)
(843) 576-5392
Entity
Organization
Contact information
Practice address
3236 LANDMARK DR, NORTH CHARLESTON, SC 29418-8488
(843) 576-5392
Mailing address
3236 LANDMARK DR, NORTH CHARLESTON, SC 29418-8488
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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