Organization
POSITIVE GENERATION IN CHRIST, INCORPORATED
Active
Parent organization
POSITIVE GENERATION IN CHRIST, INCORPORATED
Organization subpart
Yes
Provider details
NPI number
Legal business name
POSITIVE GENERATION IN CHRIST, INCORPORATED
Authorized official
IMMACULA SAINT LOUIS MD (MEDICAL DIRECTOR)
(843) 879-4763
Entity
Organization
Contact information
Practice address
608 GREGG AVE # 102103, FLORENCE, SC 29501-4317
(252) 641-4522
(252) 641-5461
Mailing address
PO BOX 1634, TARBORO, NC 27886-1634
(252) 641-4522
(252) 641-5461
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942562541
—
NC
05
—
GP9424
—
SC
Enumeration date
09/20/2019
Last updated
06/07/2022
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