Organization
ONE-EIGHTY PLACE
Active
Other names
One80 Place
Organization subpart
No
Provider details
NPI number
Authorized official
SELENA WILSON (CHIEF PROGRAM OFFICER)
(843) 737-8382
Entity
Organization
Contact information
Practice address
35 WALNUT ST, CHARLESTON, SC 29403-4514
(843) 723-9477
Mailing address
PO BOX 20038, CHARLESTON, SC 29413-0038
(843) 737-8382
(843) 737-8382
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SC
—
SC
Enumeration date
08/10/2015
Last updated
08/10/2015
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