Mind Renewal Services, Llc | |
439 Congaree Rd Greenville SC 29607-2867 | |
(864) 509-9087 | |
(864) 509-9072 |
Full Name | Mind Renewal Services, Llc |
---|---|
Speciality | Social Worker - Clinical |
Location | 439 Congaree Rd, Greenville, South Carolina |
Authorized Official Name and Position | Brandy Thompson-fisher (CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 4438676663 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mind Renewal Services, Llc 439 Congaree Rd Greenville SC 29607-2867 Ph: (864) 509-9087 | Mind Renewal Services, Llc 439 Congaree Rd Greenville SC 29607-2867 Ph: (864) 509-9087 |
NPI Number | 1447679519 |
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Provider Enumeration Date | 04/15/2014 |
Last Update Date | 04/15/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447679519 | NPI | - | NPPES |
SW1164 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 10538 (South Carolina) | Primary |
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