ERNEST E. KENNEDY CENTER NPI 1750406476

NPI Information

NPI: 1750406476
Provider Name: ERNEST E. KENNEDY CENTER
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

CLIA Number: 42D2053636

Address:
306 AIRPORT DR
MONCKS CORNER, SC
ZIP 29461
Phone: (843) 719-3000
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ERNEST E. KENNEDY CENTER is a professional counselor in Moncks Corner, SC. ERNEST E. KENNEDY CENTER NPI is 1750406476. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

306 AIRPORT DR
MONCKS CORNER, SC
ZIP 29461-629
Phone: (843) 719-3000
Fax: (843) 719-3025

The provider's authorized official is Jerome Tilghman .
The authorized official title is Director Of Clinical Services and has the following contact phone number (843) 719-3000.

The CLIA number assigned to this NPI record is 42D2053636 - other - outpatient substance abus with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/20/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	3396	SOUTH CAROLINA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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