| Ernest E. Kennedy Center | |
|
306 Airport Dr Moncks Corner SC 29461-2629 | |
| (843) 719-3000 | |
| (843) 719-3025 |
| Full Name | Ernest E. Kennedy Center |
|---|---|
| Speciality | Counselor - Professional |
| Location | 306 Airport Dr, Moncks Corner, South Carolina |
| Authorized Official Name and Position | Jerome Tilghman (DIRECTOR OF CLINICAL SERVICES) |
| Authorized Official Contact | 8437193000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ernest E. Kennedy Center 306 Airport Dr Moncks Corner SC 29461-2629 Ph: (843) 719-3000 | Ernest E. Kennedy Center 306 Airport Dr Moncks Corner SC 29461-2629 Ph: (843) 719-3000 |
| NPI Number | 1750406476 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750406476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 3396 (South Carolina) | Primary |
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