| Providing H.o.p.e. By Srj | |
|
2100 Charlie Hall Blvd Charleston SC 29414-5832 | |
| (843) 852-4100 | |
| Not Available |
| Full Name | Providing H.o.p.e. By Srj |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2100 Charlie Hall Blvd, Charleston, South Carolina |
| Authorized Official Name and Position | Sonya R Jenkins (OWNER) |
| Authorized Official Contact | 8435572760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providing H.o.p.e. By Srj 3305 Goldenrod St North Charleston SC 29405-7866 Ph: (843) 864-3679 | Providing H.o.p.e. By Srj 2100 Charlie Hall Blvd Charleston SC 29414-5832 Ph: (843) 852-4100 |
| NPI Number | 1891303988 |
|---|---|
| Provider Enumeration Date | 07/15/2020 |
| Last Update Date | 03/19/2021 |
| Certification Date | 03/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891303988 | NPI | - | NPPES |
| 1760596480 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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