Organization
HAMMOCKS ON THE EDISTO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM JONAS COATSWORTH MA, LPC, LAC, CAC-II (CEO/CHIEF OF CLINICAL SERVICES)
(843) 806-3414
Entity
Organization
Contact information
Practice address
2137 HOPE PLANTATION LANE, JACKSONBORO, SC 29452
(843) 276-9326
Mailing address
PO BOX 130, JACKSONBORO, SC 29452-0130
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/19/2019
Last updated
12/16/2020
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