| Earnest E Kennedy Center | |
|
306 Airport Dr Moncks Corner SC 29461-2629 | |
| (843) 719-3000 | |
| Not Available |
| Full Name | Earnest E Kennedy Center |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 306 Airport Dr, Moncks Corner, South Carolina |
| Authorized Official Name and Position | Jerome Tilghman (DIRECTOR) |
| Authorized Official Contact | 8437193001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Earnest E Kennedy Center 96 Wisteria Rd Goose Creek SC 29445-3495 Ph: (843) 797-7871 | Earnest E Kennedy Center 306 Airport Dr Moncks Corner SC 29461-2629 Ph: (843) 719-3000 |
| NPI Number | 1881207652 |
|---|---|
| Provider Enumeration Date | 08/31/2020 |
| Last Update Date | 08/31/2020 |
| Certification Date | 08/26/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881207652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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