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410 Oakland Ave Rock Hill SC 29730-3530 | |
| (803) 324-1976 | |
| (803) 324-4578 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 410 Oakland Ave, Rock Hill, South Carolina |
| Authorized Official Name and Position | Shirley King Miller (PRESIDENT) |
| Authorized Official Contact | 8033241976 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
410 Oakland Ave Rock Hill SC 29730-3530 Ph: (803) 324-1976 | 410 Oakland Ave Rock Hill SC 29730-3530 Ph: (803) 324-1976 |
| NPI Number | 1780865378 |
|---|---|
| Provider Enumeration Date | 11/24/2007 |
| Last Update Date | 11/24/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780865378 | NPI | - | NPPES |
| 3645P0809X | Other | SC | PSYCH CNS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CSM1561 (South Carolina) | Primary |
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