Seed Harvest Time Residential Behavioral Services, LLC
Organization Active NPI Counselor · Kingstree, SC
NPI 1376976837 · NPPES record last updated Aug 19, 2013
Key facts
- NPI
- 1376976837
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Counselor 101Y00000X
- Legal business name
- SEED HARVEST TIME RESIDENTIAL BEHAVIORAL SERVICES, LLC
- Practice address
- 209 Hampton Ave
Kingstree, SC 29556-3415 - Phone
- (843) 401-0005
- Fax
- (843) 401-0006
- NPI assigned
- Aug 19, 2013
- Organization subpart
- No
Authorized official
- Name
- Rosalind Gamble, M.A.,PMHC
- Title
- Clinical Director
- Phone
- (843) 319-7843
Corporate family (same tax ID) 1
Practitioners 2
-
Betty Green, M.A.
-
Bridgette Rodgers, MS.PSYCH, BSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210209001577 | SC | Part B Supplier - Mass Immunization (Roster Biller Only) | 6406261254 | Practice locations: Greeleyville, SC |
National Provider Directory
- Tax ID family
- Seed Harvest Time Residential Behavioral Services LLC
Locations
209 Hampton Ave
Kingstree, SC 29556
Phone (843) 401-0005
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | Yes |
Addresses
Primary practice location
209 Hampton Ave
Kingstree, SC 29556-3415
Mailing address
444 Manning Hwy
Greeleyville, SC 29056-9299
Phone (843) 319-7843
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396044988 | Other | SC | NPI |
| 131BHS | Medicaid | SC |
Other providers in Kingstree, SC
- Louis O Schwartz Jr.
- Cena M Scott
- Hope Scott
- Jessie M Scott
- Shelia Renee Scott
- Woodrena Cherise Segres
- Sharing Hope Healthcare, Inc.
- Shauna M. Van Horn
- Aisha Singletary
- Evelena Singletary
All providers in Kingstree, SC · Counselor in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.