Healthcare Provider Details

I. General information

NPI: 1871973321
Provider Name (Legal Business Name): TOGETHER WE WILL GROW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2015
Last Update Date: 05/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9005 TWO NOTCH RD
COLUMBIA SC
29223-5850
US

IV. Provider business mailing address

PO BOX 8804
COLUMBIA SC
29202-8804
US

V. Phone/Fax

Practice location:
  • Phone: 704-222-2810
  • Fax:
Mailing address:
  • Phone: 704-222-2810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: CARMEN JIMENEZ
Title or Position: DIRECTOR
Credential: MSW, LCSW, LISWCP
Phone: 704-222-2810