Organization
SEED HARVEST TIME RESIDENTIAL BEHAVIORAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSALIND GAMBLE M.A.,PMHC (CLINICAL DIRECTOR)
(843) 319-7843
Entity
Organization
Contact information
Practice address
209 HAMPTON AVE, KINGSTREE, SC 29556-3415
(843) 401-0005
(843) 401-0006
Mailing address
444 MANNING HWY, GREELEYVILLE, SC 29056-9299
(843) 319-7843
(843) 401-0006
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131BHS
—
SC
01
—
1396044988
NPI
SC
Enumeration date
08/19/2013
Last updated
08/19/2013
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