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Organization

FOREST FAMILY CARE, INC

Active
Other names
Forest Family Care
Organization subpart
No

Provider details

NPI number
Authorized official
JESSICA GRACE SMITH CHASSE FNP-C (OWNER/CEO)
(843) 903-4500
Entity
Organization

Contact information

Practice address
3874 RENEE DR UNIT B, MYRTLE BEACH, SC 29579-4358
(843) 903-4500
(843) 903-4505
Mailing address
3874 RENEE DR UNIT B, MYRTLE BEACH, SC 29579-4358
(843) 997-2380
(843) 903-4505

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F2018
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5747
SC
01
NP5615
MEDICAID ID
SC
Enumeration date
07/09/2011
Last updated
03/22/2022
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