Organization
ELI COLLINS FOUNDATION FOR PREMATURE BABIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIA SELENE TISDALE-SHAW (EXECUTIVE DIRECTOR)
(843) 355-5625
Entity
Organization
Contact information
Practice address
137 E MILL ST, KINGSTREE, SC 29556-3427
(843) 355-5625
(843) 355-5627
Mailing address
137 E MILL ST, KINGSTREE, SC 29556-3427
(843) 355-5625
(843) 355-5627
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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