Healthcare Provider Details

I. General information

NPI: 1447904669
Provider Name (Legal Business Name): SOS HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2022
Last Update Date: 02/07/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5276 HIGHWAY 17 BUSINESS
MURRELLS INLET SC
29576-5214
US

IV. Provider business mailing address

5276 HIGHWAY 17 BUSINESS
MURRELLS INLET SC
29576-5214
US

V. Phone/Fax

Practice location:
  • Phone: 843-712-1225
  • Fax: 843-712-1225
Mailing address:
  • Phone: 843-712-1225
  • Fax: 843-712-1225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELISSA GIEBEL
Title or Position: OFFICE MANAGER
Credential:
Phone: 843-712-1225