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199 S Herlong Ave Rock Hill SC 29732-1186 | |
| (803) 324-1800 | |
| (803) 328-3831 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 199 S Herlong Ave, Rock Hill, South Carolina |
| Authorized Official Name and Position | Kerri Mcguire (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8033236851 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 4437 Rock Hill SC 29732-6437 Ph: (803) 324-1800 | 199 S Herlong Ave Rock Hill SC 29732-1186 Ph: (803) 324-1800 |
| NPI Number | 1255334009 |
|---|---|
| Provider Enumeration Date | 05/24/2005 |
| Last Update Date | 10/30/2023 |
| Certification Date | 10/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255334009 | NPI | - | NPPES |
| AD12YK-SC | Medicaid | SC | |
| 19121 | Other | CARF CERTIFICATION NUMBER | |
| L00915 | Medicaid | SC |
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