Organization Name: | JOYCE C GREGORY |
NPI Number: | 1033499827 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOYCE C GREGORY (OWNER/ADMINISTRATOR) |
Mailing Address: | 2415 Fork Shoals Rd Piedmont |
State: | SC US |
Postal Code: | 29673 |
Phone Number: | 8642990716 |
Fax Number: | 8642995347 |
NPI Enumeration Date: | 08/24/2011 |
NPI Last Update Date: | 08/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | CRC-0556 |
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. |