SHORELINE BEHAVIORAL HEALTH SERVICE (NPI# 1912345893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912345893 |
| Entity Type | Organization |
| Organization Name | SHORELINE BEHAVIORAL HEALTH SERVICE |
| Practice Address |
626 Tyson Dr Pawleys Island SC 29585-6925 |
| Practice Telephone | 8433186221 |
| Mailing Telephone | 8433186221 |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2013-06-12 |
| Authorized Official Name | MR. CHARLES BELL (DIRECTOR OF TREATMENT SERVICES) |
| Authorized Official Telephone | 8433658884 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
1112301 | SC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | SCAADAC | 1112301 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SHORELINE BEHAVIORAL HEALTH SERVICE | 2404 Wise Rd, Conway, SC 29526-5521 |
| Street Address |
626 TYSON DR |
| City | PAWLEYS ISLAND |
| State | SC |
| Zip Code | 29585-6925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790303923 | Susan Kraus | Counselor | 1032 Algonquin Dr., 963-h, Pawleys Island, SC 29585 | 2020-07-14 |
| 1831737436 | Mary Ruth Blair | Counselor | 10689 Ocean Highway, Pawleys Island, SC 29585 | 2019-12-13 |
| 1518437110 | David Patrick Hanley | Home Health | 10698 Ocean Highway, Suite 100, Pawleys Island, SC 29585 | 2018-11-27 |
| 1154860369 | Danielle Olivia Woodley | Nurse Practitioner | 201 Business Center Dr., Pawleys Island, SC 29585 | 2017-02-21 |
| 1992241145 | Nichole Marie Evans | Nurse Practitioner | 10317 Ocean Highway 17 South, Pawleys Island, SC 29585 | 2017-01-11 |
| 1922559152 | Camri K Monaghan | Occupational Therapist | 120 Lakes of Litchfield Dr., Pawleys Island, SC 29585 | 2016-10-24 |
| 1245785666 | Hannah Rebecca Willis Rustin | Dentist | 34 Business Center Dr, Pawleys Island, SC 29585 | 2016-08-16 |
| 1750700894 | Veronica Seitzinger | Social Worker | 49 Pond View Dr, Pawleys Island, SC 29585 | 2014-04-15 |
| 1578813341 | Anne Marie Floyd | Physical Therapist | 120 Lakes At Litchfield Drive, Pawley's Island, SC 29585 | 2012-09-19 |
| 1356612170 | Jean C. Cross | Social Worker | Alston Rd, Pawleys Island, SC 29585 | 2012-01-25 |
| Find all providers in zip 29585 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356893416 | Solutions Recovery Center, Inc. | Clinic/Center | 520 Lowndes Hill Rd, Greenville, SC 29607-1405 | 2016-10-25 |
| 1922487610 | Cornerstone Project Sc, LLC | Clinic/Center | 1919 Hampton St, Columbia, SC 29201-3535 | 2015-05-27 |
| 1801131420 | Recoverylife, LLC | Clinic/Center | 2246 Sumter St, Columbia, SC 29201-1932 | 2012-12-07 |
| 1780934976 | Pavillon Greenville Outpatient Services | Clinic/Center | 101 Pelham Commons Blvd, Greenville, SC 29615-4974 | 2012-09-14 |
| 1437383403 | Center for Behavioral Health South Carolina, Inc | Clinic/Center | 2301 Cosgrove Ave Ste F, North Charleston, SC 29405-7663 | 2009-05-06 |
| 1376691022 | Saluda County Alcohol & Drug Abuse Comm | Clinic/Center | 204 N Ramage St, Saluda, SC 29138-1359 | 2007-01-08 |
| 1487665055 | Fairfield Behavioral Health Services | Clinic/Center | 178 Us Highway 321 Bypass N., Winnsboro, SC 29180 | 2006-08-10 |
| 1053340273 | Greenwood-edgefield-mccormick-abbeville Commission On Alcohol and Drug | Clinic/Center | 1420 Spring St, Greenwood, SC 29646-4057 | 2006-07-01 |
| 1972532075 | Laurens County Commission On Alcohol and Drug Abuse | Clinic/Center | 219 Human Services Road, Clinton, SC 29325 | 2006-07-01 |
| 1972574101 | The Ernest E. Kennedy Center | Clinic/Center | 306 Airport Dr, Moncks Corner, SC 29461-2629 | 2006-01-27 |
| Find all providers with the same taxonomy | ||||
| City | PAWLEYS ISLAND |
| Zip Code | 29585 |
Please comment or provide details below to improve the information on SHORELINE BEHAVIORAL HEALTH SERVICE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.