| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3439 Casey St, Loris, South Carolina |
| Authorized Official Name and Position | Howard Calhoun (PRESIDENT/CEO) |
| Authorized Official Contact | 8437567171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
586 Highway 701 N Suite A Loris SC 29569-2473 Ph: (843) 756-7171 | 3439 Casey St Loris SC 29569 Ph: (843) 756-7171 |
| NPI Number | 1235583378 |
|---|---|
| Provider Enumeration Date | 04/14/2016 |
| Last Update Date | 07/12/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235583378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (South Carolina) | Primary |
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