Healthcare Provider Details

I. General information

NPI: 1790649689
Provider Name (Legal Business Name): ORCHID MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 ROBERTS AVE
YORK SC
29745-1303
US

IV. Provider business mailing address

114 ROBERTS AVE
YORK SC
29745-1303
US

V. Phone/Fax

Practice location:
  • Phone: 803-681-0869
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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

VIII. Authorized Official

Name: AMBER MINER
Title or Position: OWNER
Credential:
Phone: 803-981-3886