| Organization Name: | WILDERNESS WAY CAMP SCHOOL INC |
| NPI Number: | 1245276906 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEN R EDGAR (EXECUTIVE DIRECTOR) |
| Mailing Address: | 175 Camp School Ln Fair Play |
| State: | SC US |
| Postal Code: | 29643 |
| Phone Number: | 8649720611 |
| Fax Number: | 8649722045 |
| NPI Enumeration Date: | 06/21/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |