Earnest E Kennedy Center
Counselor, Addiction (Substance Use Disorder) in Moncks Corner, SC. Organization (NPI-2).
NPI number1881207652
StatusActive
Last updated in NPPESAug 31, 2020
Details
- NPI
- 1881207652
- Entity type
- Organization (NPI-2)
- Legal business name
- Earnest E Kennedy Center
- Organization subpart
- No
- Enumeration date
- Aug 31, 2020
- Certification date
- Aug 26, 2020
- Last updated
- Aug 31, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
Practice location
306 Airport DrMoncks Corner, SC 29461-2629
Phone 843-719-3000
Mailing address
96 Wisteria RdGoose Creek, SC 29445-3495
Phone 843-797-7871
Other practice locations
96 Wisteria Rd
Goose Creek, SC 29445-3495
Goose Creek, SC 29445-3495
Phone 843-797-7871
Authorized official
Jerome Tilghman
Director
8437193001
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