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General NPI Number Information
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NPI Number | 1407113723
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Entity Type | Organization
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Legal Business Name | SORINITY SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 4000 FABER PLACE DR STE 300
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City | CHARLESTON
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State | SC
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Zip | 29405-8587
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Country | US
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Telephone | 866-273-6377
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Fax | 866-364-7607
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Provider Business Mailing Address
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Address Line | 4000 FABER PLACE DR STE 300
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City | CHARLESTON
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State | SC
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Zip | 29405-8587
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Country | US
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Telephone | 866-273-6377
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Fax | 866-364-7607
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Authorized Official
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Title or Position | OWNER
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Name | ALVINA ROBERTS
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Credential |
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Telephone | 866-273-6377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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