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General NPI Number Information
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NPI Number | 1134232671
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Entity Type | Organization
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Legal Business Name | PALMETTO LOWCOUNTRY BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 05/02/2011
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Provider Practice Location Address
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Address Line | 2777 SPEISSEGGER DR
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City | NORTH CHARLESTON
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State | SC
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Zip | 29405-8229
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Country | US
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Telephone | 843-747-5830
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Fax | 843-745-5170
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Provider Business Mailing Address
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Address Line | 2777 SPEISSEGGER DR
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City | NORTH CHARLESTON
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State | SC
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Zip | 29405-8229
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Country | US
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Telephone | 843-747-5830
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Fax | 843-745-5170
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Authorized Official
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Title or Position | SR VP CFO
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Name | STEVE FILTON
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Credential |
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Telephone | 610-768-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | RTC011
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | HTL729
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License Number State | SC
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