| Rooted Wings Llc | |
|
131 Cameron St Pacolet SC 29372-2838 | |
| (864) 398-9322 | |
| (888) 707-1002 |
| Full Name | Rooted Wings Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 131 Cameron St, Pacolet, South Carolina |
| Authorized Official Name and Position | Stacey L Jackson (OWNER) |
| Authorized Official Contact | 8643989322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rooted Wings Llc 131 Cameron St Pacolet SC 29372-2838 Ph: (864) 398-9322 | Rooted Wings Llc 131 Cameron St Pacolet SC 29372-2838 Ph: (864) 398-9322 |
| NPI Number | 1629868252 |
|---|---|
| Provider Enumeration Date | 05/07/2025 |
| Last Update Date | 05/08/2025 |
| Certification Date | 05/08/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629868252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Crossroads Youth Ranch Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 344 Flemming Road, Pacolet, SC 29372 Phone: 360-920-1084 |