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GRACEFUL LIVING BEHAVIORAL SUPPORT NPI 1245779164


NPI Information

NPI: 1245779164
Provider Name: GRACEFUL LIVING BEHAVIORAL SUPPORT
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 42D2265152

Address:
3236 LANDMARK DR
NORTH CHARLESTON, SC
ZIP 29418
Phone: (843) 576-5392
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GRACEFUL LIVING BEHAVIORAL SUPPORT is a community behavioral health in North Charleston, SC. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. GRACEFUL LIVING BEHAVIORAL SUPPORT NPI is 1245779164. The provider is registered as an organization entity type.

The provider's business location address is:

3236 LANDMARK DR
NORTH CHARLESTON, SC
ZIP 29418-488
Phone: (843) 576-5392

The provider's authorized official is Modupe Sarumi .
The authorized official title is Executive Director and has the following contact phone number (843) 576-5392.

The CLIA number assigned to this NPI record is 42D2265152 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/13/2017 and was last updated on 2/13/2017.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral HealthYes

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: 4/28/2024

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