Organization
THE LAKEHOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY D BROWN JR. (CEO)
(803) 331-0658
Entity
Organization
Contact information
Practice address
1545 WATEREE DAM RD, RIDGEWAY, SC 29130-9162
(803) 272-0412
(803) 272-0412
Mailing address
1545 WATEREE DAM RD, RIDGEWAY, SC 29130-9162
(803) 272-0412
(803) 272-0412
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6042
SC
Other
Enumeration date
06/22/2010
Last updated
06/22/2010
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