| Rock Hill Va | |
|
205 Piedmont Blvd Rock Hill SC 29732-1836 | |
| (803) 366-4848 | |
| Not Available |
| Full Name | Rock Hill Va |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 205 Piedmont Blvd, Rock Hill, South Carolina |
| Authorized Official Name and Position | Tawney Dively (ADMINISTRATOR) |
| Authorized Official Contact | 8033664848 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rock Hill Va 205 Piedmont Blvd Rock Hill SC 29732-1836 Ph: () - | Rock Hill Va 205 Piedmont Blvd Rock Hill SC 29732-1836 Ph: (803) 366-4848 |
| NPI Number | 1972753622 |
|---|---|
| Provider Enumeration Date | 09/30/2008 |
| Last Update Date | 09/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972753622 | NPI | - | NPPES |
| QMO740 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 36 (South Carolina) | Primary |
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