| Pine Heights Rehabilitation Services | |
|
1117 Georgia Ave North Augusta SC 29841-3012 | |
| (803) 752-0404 | |
| (888) 384-2250 |
| Full Name | Pine Heights Rehabilitation Services |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 1117 Georgia Ave, North Augusta, South Carolina |
| Authorized Official Name and Position | Edgar Joe Holt (CEO/CLINICAL DIRECTOR) |
| Authorized Official Contact | 8037520404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Heights Rehabilitation Services 1117 Georgia Ave North Augusta SC 29841-3012 Ph: (803) 752-0404 | Pine Heights Rehabilitation Services 1117 Georgia Ave North Augusta SC 29841-3012 Ph: (803) 752-0404 |
| NPI Number | 1912577982 |
|---|---|
| Provider Enumeration Date | 06/30/2021 |
| Last Update Date | 06/30/2021 |
| Certification Date | 06/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912577982 | NPI | - | NPPES |
| PL1369 | Medicaid | SC | |
| 1376642884 | Other | SC | PROVIDER ID # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | () | Primary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
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