Organization
LOW COUNTRY OUTREACH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANITA ROSSER JOHNSON (ADMINISTRATOR)
(803) 546-0526
Entity
Organization
Contact information
Practice address
425 S WHEELER AVE, PROSPERITY, SC 29127-9347
(803) 546-0526
Mailing address
7001 SAINT ANDREWS RD, STE 319, COLUMBIA, SC 29212-1137
(803) 546-0526
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/28/2006
Last updated
08/22/2020
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