Healthcare Provider Details

I. General information

NPI: 1114394376
Provider Name (Legal Business Name): FOCUS POINTE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2015
Last Update Date: 08/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E MADISON ST SUITE E
DILLON SC
29536-2466
US

IV. Provider business mailing address

100 E MADISON ST SUITE E
DILLON SC
29536-2466
US

V. Phone/Fax

Practice location:
  • Phone: 910-263-3660
  • Fax:
Mailing address:
  • Phone: 910-263-3660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. VIRANDA L DESHIELDS
Title or Position: DIRECTOR
Credential: B.S.
Phone: 910-263-3660