Provider Demographics
NPI:1366110751
Name:AT YOUR PLACE HEALTHCARE
Entity type:Organization
Organization Name:AT YOUR PLACE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:MCQUEEN
Authorized Official - Last Name:FLING
Authorized Official - Suffix:
Authorized Official - Credentials:AGNP
Authorized Official - Phone:843-289-9061
Mailing Address - Street 1:404 MCTAVISH MOOR CT
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:SC
Mailing Address - Zip Code:29571-6812
Mailing Address - Country:US
Mailing Address - Phone:843-289-9061
Mailing Address - Fax:888-405-7861
Practice Address - Street 1:609 N MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:SC
Practice Address - Zip Code:29571-3033
Practice Address - Country:US
Practice Address - Phone:843-289-5061
Practice Address - Fax:843-289-5061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty