| Lakeside Family Center | |
|
219 N Highway 52 Ste R Moncks Corner SC 29461-3926 | |
| (843) 761-3325 | |
| Not Available |
| Full Name | Lakeside Family Center |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 219 N Highway 52, Moncks Corner, South Carolina |
| Authorized Official Name and Position | Elizabeth Louise Vinson (OWNER) |
| Authorized Official Contact | 8437613325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Family Center 219 N Highway 52 Ste R Moncks Corner SC 29461-3926 Ph: (843) 761-3325 | Lakeside Family Center 219 N Highway 52 Ste R Moncks Corner SC 29461-3926 Ph: (843) 761-3325 |
| NPI Number | 1902177520 |
|---|---|
| Provider Enumeration Date | 01/13/2012 |
| Last Update Date | 01/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902177520 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 4776 (South Carolina) | Primary |
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