Organization
SHORELINE BEHAVIORAL HEALTH SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES BELL (DIRECTOR OF TREATMENT SERVICES)
(843) 365-8884
Entity
Organization
Contact information
Practice address
626 TYSON DR, PAWLEYS ISLAND, SC 29585-6925
(843) 318-6221
Mailing address
626 TYSON DR, PAWLEYS ISLAND, SC 29585-6925
(843) 318-6221
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
1112301
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1112301
SCAADAC
SC
Enumeration date
06/12/2013
Last updated
06/12/2013
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