| Pieces 2 Peace Wellness Center, Llc | |
|
1105 Belleview St Ste 103 Columbia SC 29201-1839 | |
| (803) 250-5198 | |
| Not Available |
| Full Name | Pieces 2 Peace Wellness Center, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1105 Belleview St Ste 103, Columbia, South Carolina |
| Authorized Official Name and Position | Anna B. Gantt-gordon (CO-OWNER) |
| Authorized Official Contact | 8032505198 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pieces 2 Peace Wellness Center, Llc Po Box 9054 Columbia SC 29290-0054 Ph: (803) 250-5198 | Pieces 2 Peace Wellness Center, Llc 1105 Belleview St Ste 103 Columbia SC 29201-1839 Ph: (803) 250-5198 |
| NPI Number | 1902403116 |
|---|---|
| Provider Enumeration Date | 10/01/2020 |
| Last Update Date | 10/01/2020 |
| Certification Date | 10/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902403116 | NPI | - | NPPES |
| PC2197 | Medicaid | SC | |
| QMP000005514755 | Other | SC | MOLINA HEALTHCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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