Graceful Living Behavioral Support

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

GRACEFUL LIVING BEHAVIORAL SUPPORT

Practice address

3236 Landmark Dr
North Charleston, SC 29418-8488

Phone

(843) 576-5392

NPI assigned

Feb 13, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Modupe Sarumi, PHARMD, MPH

Title

Executive Director

Phone

(843) 576-5392

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1245779164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3236 LANDMARK DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294188488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 LANDMARK DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294188488",
            "telephone_number": "843-576-5392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEFUL LIVING BEHAVIORAL SUPPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "SARUMI",
        "authorized_official_first_name": "MODUPE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "843-576-5392",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD, MPH"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Community/Behavioral Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.