| Positive Influences, Inc | |
|
200 N Brooks St Kingstree SC 29556-3544 | |
| (252) 916-9466 | |
| Not Available |
| Full Name | Positive Influences, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 200 N Brooks St, Kingstree, South Carolina |
| Authorized Official Name and Position | Tiffany Dowell (CEO) |
| Authorized Official Contact | 2529169466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Positive Influences, Inc Po Box 1332 Greenville NC 27834-1332 Ph: (252) 916-9466 | Positive Influences, Inc 200 N Brooks St Kingstree SC 29556-3544 Ph: (252) 916-9466 |
| NPI Number | 1093126500 |
|---|---|
| Provider Enumeration Date | 05/19/2014 |
| Last Update Date | 01/18/2021 |
| Certification Date | 01/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093126500 | NPI | - | NPPES |
| 8302473 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (South Carolina) | Primary |
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