Provider Demographics
NPI:1992546493
Name:CAROLINA CONNECTIONS & INTERVENTIONS LLC
Entity type:Organization
Organization Name:CAROLINA CONNECTIONS & INTERVENTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHEMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUSACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-409-9240
Mailing Address - Street 1:1951 PISGAH RD
Mailing Address - Street 2:MAILBOX #9
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501
Mailing Address - Country:US
Mailing Address - Phone:843-409-9240
Mailing Address - Fax:888-304-1446
Practice Address - Street 1:1951 PISGAH RD
Practice Address - Street 2:MAILBOX #9
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501
Practice Address - Country:US
Practice Address - Phone:843-409-9240
Practice Address - Fax:888-304-1446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency