Childrens Recovery Center

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

License

SC0277 Issued in SC

Legal business name

CHILDRENS RECOVERY CENTER

Practice address

1801 Legion St
Myrtle Beach, SC 29577-3113

Phone

(843) 448-3400

Fax

(843) 626-5040

NPI assigned

Jun 15, 2009

Last updated

Jun 15, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Nicole Bandel

Title

Business Manager

Phone

(843) 448-3400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245024000000",
    "number": "1568699833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 LEGION ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295773113",
            "telephone_number": "843-448-3400",
            "fax_number": "843-626-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 LEGION ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295773113",
            "telephone_number": "843-448-3400",
            "fax_number": "843-626-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-15",
        "last_updated": "2009-06-15",
        "status": "A",
        "authorized_official_last_name": "BANDEL",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "843-448-3400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "SC",
            "license": "SC0277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E712861106",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Voluntary or Charitable Agency in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Voluntary or Charitable Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; 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.