NPI 1699929612
Southside Res. Care
Practice location
- Address
- 425 S. Wheeler Ave, Pros, SC 29127
- Phone
- (803) 364-0022
- Fax
- (803) 364-8250
- Mailing address
- 425 S. Wheeler Ave, Prosperity, SC 29127
Authorised official
- Name
- Roy L. Bowers
- Title
- Ceo
- Phone
- (803) 364-0022
Registered specialties
Mental Illness Community Based Residential Treatment Facility
Primary
Registry record
- NPI
- 1699929612
- Entity type
- Organization
- NPI issued
- 5 Nov 2008
- Record last updated
- 5 Nov 2008
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.