Organization
JADE COMMUNITY RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIA M. VELASCO (ADMINISTRATOR/OWNER)
(843) 853-6885
Entity
Organization
Contact information
Practice address
3 & 5 CUNNINGTON STREET, CHARLESTON, SC 39405
(843) 853-0299
Mailing address
POST OFFICE BOX 21877, 3 & 5 CUNNINGTON STREET, CHARLESTON, SC 29405
(843) 853-0299
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
CRC 1123
SC
Other
Enumeration date
12/04/2008
Last updated
12/04/2008
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