| Seastar | |
|
1456 Pine Island View Mount Pleasant SC 29464 | |
| (843) 325-3504 | |
| Not Available |
| Full Name | Seastar |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1456 Pine Island View, Mount Pleasant, South Carolina |
| Authorized Official Name and Position | Melissa V. Ruge (DIRECTOR OF THERAPUETIC SERVICES) |
| Authorized Official Contact | 8433253504 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Seastar 1456 Pine Island View Mount Pleasant SC 29464 Ph: () - | Seastar 1456 Pine Island View Mount Pleasant SC 29464 Ph: (843) 325-3504 |
| NPI Number | 1841528551 |
|---|---|
| Provider Enumeration Date | 11/19/2009 |
| Last Update Date | 11/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841528551 | NPI | - | NPPES |
| EX8636 | Medicaid | SC | |
| EX6889 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-09-5328 (* (Not Available)) | Primary |
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