Organization Name: | AMIKIDS PALMETTO, INC. |
NPI Number: | 1013256080 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICKIE HARDY (EXECUTIVE DIRECTOR) |
Mailing Address: | 780 T Bishop Rd Jonesville |
State: | SC US |
Postal Code: | 293532342 |
Phone Number: | 8646740458 |
Fax Number: | 8646740460 |
NPI Enumeration Date: | 02/11/2013 |
NPI Last Update Date: | 02/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | SR-0001004332001-CCI |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | SC |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |