Organization
JUMPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMMY L WADE (EXECUTIVE)
(803) 447-1291
Entity
Organization
Contact information
Practice address
222 JW NEAL CIRCLE, HOPKINS, SC 29061
(803) 447-1291
Mailing address
PO BOX 24463, COLUMBIA, SC 29224-4463
(803) 447-1291
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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