Healthcare Provider Details

I. General information

NPI: 1164766499
Provider Name (Legal Business Name): REMBERT AREA COMMUNITY COALITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2012
Last Update Date: 11/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8455 CAMDEN HWY
REMBERT SC
29128-8664
US

IV. Provider business mailing address

8455 CAMDEN HWY POB 186
REMBERT SC
29128-8664
US

V. Phone/Fax

Practice location:
  • Phone: 803-432-2001
  • Fax: 803-432-2404
Mailing address:
  • Phone: 803-432-2001
  • Fax: 803-432-2404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateSC

VIII. Authorized Official

Name: DR. JUANITA GREGGS BRITTON
Title or Position: CEO
Credential: PHD
Phone: 803-420-1255