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Organization

ENVISION HEALTHCARE SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KIMBERLY LATRICE HASTIE (CEO/PRESIDENT)
(803) 236-7424
Entity
Organization

Contact information

Practice address
145 HIGHWAY 15-401 BYP W STE 9, BENNETTSVILLE, SC 29512-4359
(803) 236-7424
(843) 868-5020
Mailing address
145 HIGHWAY 15-401 BYP W STE 9, BENNETTSVILLE, SC 29512-4359
(843) 456-5045
(843) 868-5020

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
104100000X
Social Worker
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
246QL0900X
Laboratory Management Specialist/Technologist
246RP1900X
Phlebotomy Technician
247ZC0005X
Clinical Laboratory Director (Non-physician)
251S00000X
Community/Behavioral Health Agency
Primary
253J00000X
Foster Care Agency
343900000X
Non-emergency Medical Transport (VAN)

Other

Enumeration date
06/02/2010
Last updated
06/10/2024
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