| Luminary Love Llc | |
|
112 Ironwood Trl Apt F North Charleston SC 29418-2098 | |
| (843) 330-3810 | |
| Not Available |
| Full Name | Luminary Love Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 112 Ironwood Trl Apt F, North Charleston, South Carolina |
| Authorized Official Name and Position | Patricia Raynor (OWNER/OPERATOR) |
| Authorized Official Contact | 8433303810 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Luminary Love Llc Po Box 40914 North Charleston SC 29423-0914 Ph: (843) 876-1802 | Luminary Love Llc 112 Ironwood Trl Apt F North Charleston SC 29418-2098 Ph: (843) 330-3810 |
| NPI Number | 1215532197 |
|---|---|
| Provider Enumeration Date | 12/01/2020 |
| Last Update Date | 12/02/2020 |
| Certification Date | 12/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215532197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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