Organization
SONS AND DAUGHTERS OF LIGHT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN LENEAU MS LPC (OWNER)
(706) 840-6302
Entity
Organization
Contact information
Practice address
78 FOLLY ROAD BLVD STE B9 1177, CHARLESTON, SC 29407-7551
(854) 832-3603
Mailing address
78 FOLLY ROAD BLVD STE B91177, CHARLESTON, SC 29407-7551
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC2468
—
SC
Enumeration date
12/18/2023
Last updated
12/18/2023
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