NPI 1366855876

Godly Ambition of New Generation

Organisation Preferred Provider Organization Florence, SC

Practice location

Address: 3501 E Winlark Dr, Florence, SC 29506-8637
Phone: (843) 621-2696

Authorised official

Name: Deann G Lesane
Title: Program Director
Phone: (843) 621-2696

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 1042065 (SC)

Other Preferred Provider Organization providers in South Carolina →

Registry record

NPI: 1366855876
Entity type: Organization
NPI issued: 3 Jun 2014
Record last updated: 3 Jun 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.