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175 Camp School Ln Fair Play SC 29643 | |
(864) 972-0611 | |
(864) 972-2045 |
Full Name | |
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Speciality | Counselor - Mental Health |
Location | 175 Camp School Ln, Fair Play, South Carolina |
Authorized Official Name and Position | Ken R Edgar (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8649720611 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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175 Camp School Ln Fair Play SC 29643 Ph: (864) 972-0611 | 175 Camp School Ln Fair Play SC 29643 Ph: (864) 972-0611 |
NPI Number | 1245276906 |
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Provider Enumeration Date | 06/21/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1245276906 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |