Organization
CENTER OF CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY JENERETTE HORNSBY MS, LBSW (OWNER)
(803) 432-5200
Entity
Organization
Contact information
Practice address
2039 W DEKALB ST, BUILDING 1, SUITE 2, CAMDEN, SC 29020-2092
(803) 432-5200
(803) 432-5199
Mailing address
2039 W DEKALB ST, BUILDING 1, SUITE 2, CAMDEN, SC 29020-2092
(803) 432-5200
(803) 432-5199
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8724
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4217
—
SC
Enumeration date
11/13/2006
Last updated
06/11/2008
Update your record
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