Organization
PROVIDENT PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIE FOSTER BROWN (OWNER)
(803) 447-6779
Entity
Organization
Contact information
Practice address
418 BRADFORD LN, COLUMBIA, SC 29223-7131
(803) 447-6779
Mailing address
418 BRADFORD LN, COLUMBIA, SC 29223-7131
(803) 447-6779
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/23/2016
Last updated
04/23/2016
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