Organization
SOUTH CAROLINA MENTOR
Active
Parent organization
THE MENTOR NETWORK
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE MENTOR NETWORK
Authorized official
MS. JENNIFER MARY POOLE BCBA (BEHAVIORAL CONSULTANT)
(843) 513-0040
Entity
Organization
Contact information
Practice address
4 CARRIAGE LN, SUITE 302, CHARLESTON, SC 29407-6065
(843) 573-1905
(843) 573-1926
Mailing address
4 CARRIAGE LN, SUITE 302, CHARLESTON, SC 29407-6065
(843) 573-1905
(843) 573-1926
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1-13-12976
SC
252Y00000X
Early Intervention Provider Agency
1-13-12976
SC
Other
Enumeration date
03/26/2013
Last updated
03/26/2013
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