| Center Stage Community Center | |
|
1043 Phoenix St Greenwood SC 29646-3915 | |
| (864) 337-2445 | |
| Not Available |
| Full Name | Center Stage Community Center |
|---|---|
| Speciality | Voluntary Or Charitable |
| Location | 1043 Phoenix St, Greenwood, South Carolina |
| Authorized Official Name and Position | Kenneth Medows (C.E.O.) |
| Authorized Official Contact | 8643372445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Center Stage Community Center Po Box 2310 Greenwood SC 29646-0310 Ph: (864) 337-2445 | Center Stage Community Center 1043 Phoenix St Greenwood SC 29646-3915 Ph: (864) 337-2445 |
| NPI Number | 1760787824 |
|---|---|
| Provider Enumeration Date | 01/21/2011 |
| Last Update Date | 01/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760787824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2077 (South Carolina) | Secondary |
| 251V00000X | Voluntary Or Charitable | 2077 (South Carolina) | Primary |
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