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Organization

TRINITY SUPPORT GROUP, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TANYA SHADE (ADMINISTRATOR)
(803) 207-7674
Entity
Organization

Contact information

Practice address
483 SWEETGUM DR, FORT MILL, SC 29715-6927
(803) 207-7674
Mailing address
PO BOX 962, FORT MILL, SC 29716-0962
(803) 207-7674

Taxonomy

Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
SC
261QA0600X
Adult Day Care Clinic/Center
Primary

Other

Enumeration date
08/24/2010
Last updated
08/24/2010
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