Healthcare Provider Details

I. General information

NPI: 1528387040
Provider Name (Legal Business Name): MENTAL HEALTH AMERICA-BEAUFORT/JASPER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2010
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4454 BLUFFTON PARK CRES STE 108
BLUFFTON SC
29910-9040
US

IV. Provider business mailing address

PO BOX 1925
BLUFFTON SC
29910-1925
US

V. Phone/Fax

Practice location:
  • Phone: 843-757-3900
  • Fax: 843-757-8664
Mailing address:
  • Phone: 843-757-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateSC

VIII. Authorized Official

Name: MR. STEVEN ARLEIGH CAYWOOD
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 843-757-3900