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General NPI Number Information
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NPI Number | 1154196376
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Entity Type | Organization
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Legal Business Name | PALMETTO PSYCHIATRY & WELLNESS
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Dates
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Enumeration Date | 11/17/2023
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 815 ROBIN DR STE B
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City | SENECA
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State | SC
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Zip | 29678-2653
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Country | US
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Telephone | 864-614-1555
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Fax | 312-535-6816
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Provider Business Mailing Address
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Address Line | PO BOX 562
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City | SENECA
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State | SC
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Zip | 29679-0562
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Country | US
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Telephone | 860-878-8447
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Fax | 312-535-6816
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Authorized Official
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Title or Position | OWNER
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Name | CELESTE MARIE MENDEZ
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Credential | APRN
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Telephone | 860-878-8447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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