Healthcare Provider Details

I. General information

NPI: 1295470904
Provider Name (Legal Business Name): MOJO THERAPEUTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2022
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1477 EBENEZER RD STE D
ROCK HILL SC
29732-2338
US

IV. Provider business mailing address

135 E MAIN ST STE 213
ROCK HILL SC
29730-4892
US

V. Phone/Fax

Practice location:
  • Phone: 803-579-8558
  • Fax: 844-440-1981
Mailing address:
  • Phone: 803-579-8558
  • Fax: 844-440-1981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALICIA D. MULDROW
Title or Position: OWNER
Credential: MSW, LISW-CP, LCASA
Phone: 803-579-8558