Organization
MOOKIES PLACE
Active
Other names
Mookies Place Youth and Family Program
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LETISHA LYNN SMALLS (PRESIDENT)
(803) 285-8589
Entity
Organization
Contact information
Practice address
501 W MEETING ST, LANCASTER, SC 29720-2323
(803) 285-8589
(704) 919-5055
Mailing address
PO BOX 1244, LANCASTER, SC 29721-1244
(803) 285-8589
(704) 919-5055
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
251300000X
Local Education Agency (LEA)
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
SC
Other
Enumeration date
07/16/2018
Last updated
03/15/2019
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