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General NPI Number Information
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NPI Number | 1093253866
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Entity Type | Organization
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Legal Business Name | STRENGTH OF MY HEART LLC
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Dates
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Enumeration Date | 02/01/2017
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Last Update Date | 02/01/2017
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Provider Practice Location Address
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Address Line | 173 RICE TERRACE DR
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City | COLUMBIA
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State | SC
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Zip | 29229-9377
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Country | US
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Telephone | 803-814-1869
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 291315
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City | COLUMBIA
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State | SC
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Zip | 29229-0022
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Country | US
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Telephone | 803-814-1869
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Fax |
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | MRS. TASHA MICHELLE WILLIAMS
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Credential | LISW-CP
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Telephone | 803-814-1869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 9309
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License Number State | SC
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