Organization Name: | ACTIVE SC TWO, INC. |
NPI Number: | 1578603064 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CRAIG MEHNERT (COO) |
Mailing Address: | 2902 Highmarket St Georgetown |
State: | SC US |
Postal Code: | 294402918 |
Phone Number: | 8435462055 |
Fax Number: | 8435464435 |
NPI Enumeration Date: | 02/07/2007 |
NPI Last Update Date: | 06/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |