Organization
GROWING HOME SE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSE M LOPEZ CPA (VP OF FINANCE)
(803) 791-5513
Entity
Organization
Contact information
Practice address
440 KNOX ABBOTT DR, SUITE 370, CAYCE, SC 29033-4353
(803) 791-5513
(803) 739-0301
Mailing address
440 KNOX ABBOTT DR, SUITE 370, CAYCE, SC 29033-4353
(803) 791-5513
(803) 739-0301
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SR-0008300001-CPA
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
886MXH
—
SC
05
—
CBT004
—
SC
Enumeration date
12/01/2006
Last updated
08/22/2020
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