Organization
SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY ANN KENNEDY (HUMAN SERVICE SPECIALIST 1)
(843) 536-6175
Entity
Organization
Contact information
Practice address
1411 DORDIE CIR, FLORENCE, SC 29506-7368
(843) 536-6175
Mailing address
1411 DORDIE CIR, FLORENCE, SC 29506-7368
(843) 536-6175
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Enumeration date
05/12/2016
Last updated
05/12/2016
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