Organization
PINE HILL INDIAN COMMUNITY DEVELOPMENT INITIATIVE
Active
Other names
Pine Hill Health Network
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE MITCHUM MSCJ/LAW, CHW (EXECUTIVE DIRECTOR)
(803) 662-3777
Entity
Organization
Contact information
Practice address
4631 SAVANNAH HWY, NORTH, SC 29112-8180
(803) 247-2534
Mailing address
4055 COBURG LN, ORANGEBURG, SC 29115-9014
(803) 662-3377
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
08/15/2019
Last updated
09/23/2021
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