Organization
COVERED BY CHUKWU
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARAI ROSE MONTGOMERY (OUTREACH AND EQUITY DIRECTOR)
(843) 591-4546
Entity
Organization
Contact information
Practice address
3535 STARLING RD, MULLINS, SC 29574-7330
(843) 591-4546
Mailing address
3535 STARLING RD, MULLINS, SC 29574-7330
(843) 591-4546
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
251B00000X
Case Management Agency
—
—
282J00000X
Religious Nonmedical Health Care Institution
—
—
374K00000X
Religious Nonmedical Practitioner
—
—
374T00000X
Religious Nonmedical Nursing Personnel
—
—
Other
Enumeration date
07/28/2025
Last updated
08/17/2025
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