Organization
JCTA5221 ENTERPRISES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY C. PICHANY (CHIEF OFFICER)
(570) 468-5683
Entity
Organization
Contact information
Practice address
6105 N KINGS HWY, MYRTLE BEACH, SC 29577-2372
(570) 468-5683
Mailing address
276 PALM COVE CIR, MYRTLE BEACH, SC 29588-1405
(570) 468-5683
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/03/2024
Last updated
08/23/2025
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