| Blueprint For Change | |
|
1110 Paris Ave Ste A Port Royal SC 29935-2322 | |
| (843) 524-6112 | |
| (843) 524-6111 |
| Full Name | Blueprint For Change |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1110 Paris Ave Ste A, Port Royal, South Carolina |
| Authorized Official Name and Position | Julie Singleton Tabor (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Contact | 8435246112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blueprint For Change 1110 Paris Ave Ste A Port Royal SC 29935-2322 Ph: (843) 524-6112 | Blueprint For Change 1110 Paris Ave Ste A Port Royal SC 29935-2322 Ph: (843) 524-6112 |
| NPI Number | 1609052356 |
|---|---|
| Provider Enumeration Date | 01/11/2008 |
| Last Update Date | 01/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609052356 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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