Provider Demographics
NPI:1972805190
Name:CARE HOUSE OF THE PEE DEE INC
Entity type:Organization
Organization Name:CARE HOUSE OF THE PEE DEE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:D B
Authorized Official - Last Name:TEMPLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:843-629-0236
Mailing Address - Street 1:1500 PATTON DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6520
Mailing Address - Country:US
Mailing Address - Phone:843-629-0236
Mailing Address - Fax:
Practice Address - Street 1:1500 PATTON DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6520
Practice Address - Country:US
Practice Address - Phone:843-629-0236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPEHEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-19
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5008251S00000X
SC5497251S00000X
SCAPN 171363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty