Individual
SHAWN GATHERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
112 LOCHAVEN DR, 207, CHARLESTON, SC 29414-5978
(843) 256-3361
(843) 712-7290
Mailing address
112 LOCHAVEN DR, 207, CHARLESTON, SC 29414-5978
(843) 256-3361
(843) 712-7290
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
305S00000X
Point of Service
—
—
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
08/01/2016
Last updated
09/12/2016
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