Organization
POURING 4 PURPOSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICOLE DRAKE (DIRECTOR)
(336) 306-2200
Entity
Organization
Contact information
Practice address
1416 BETHLEHEM RD, HARTSVILLE, SC 29550-1716
(843) 250-6679
Mailing address
1416 BETHLEHEM RD, HARTSVILLE, SC 29550-1716
(336) 306-2200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
11/29/2016
Last updated
11/29/2016
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