| Brk Psychiatric Mental Health Services Llc | |
|
1156 Old Mcgraw Rd Eastover SC 29044-9116 | |
| (803) 353-2082 | |
| (803) 353-2082 |
| Full Name | Brk Psychiatric Mental Health Services Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1156 Old Mcgraw Rd, Eastover, South Carolina |
| Authorized Official Name and Position | Bernice Kennedy (PSYCHIATRIC MENTAL HEALTH -CNS) |
| Authorized Official Contact | 8033532082 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brk Psychiatric Mental Health Services Llc Po Box 90899 Columbia SC 29290-1889 Ph: (803) 353-2082 | Brk Psychiatric Mental Health Services Llc 1156 Old Mcgraw Rd Eastover SC 29044-9116 Ph: (803) 353-2082 |
| NPI Number | 1174196976 |
|---|---|
| Provider Enumeration Date | 07/20/2021 |
| Last Update Date | 07/20/2021 |
| Certification Date | 07/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174196976 | NPI | - | NPPES |
| NP3264 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Courtlyn House Crcf Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10508 Garners Ferry Rd, Eastover, SC 29044 Phone: 803-695-2158 Fax: 803-695-2746 |