Organization
BLACK RIVER LABS AND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FELECIA SHAVON SCOTT CPT, MA, BA PSY (OWNER)
(803) 809-0099
Entity
Organization
Contact information
Practice address
960 BERRY ST, ORANGEBURG, SC 29115-4317
(803) 809-0099
Mailing address
960 BERRY ST, ORANGEBURG, SC 29115-4317
(803) 809-0099
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
04/01/2026
Last updated
04/01/2026
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