Provider Demographics
NPI:1841085909
Name:RAGIN WELLNESS CENTER LLC
Entity type:Organization
Organization Name:RAGIN WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANIDRA
Authorized Official - Middle Name:TIANA
Authorized Official - Last Name:RAGIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:803-410-8240
Mailing Address - Street 1:249 MASTERS DR
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154-7700
Mailing Address - Country:US
Mailing Address - Phone:803-410-8240
Mailing Address - Fax:
Practice Address - Street 1:249 MASTERS DR
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29154-7700
Practice Address - Country:US
Practice Address - Phone:803-410-8240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1063166577Medicaid