NPI 1538918016

Cornelia Authorine Minnifield

Practitioner Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Longs, SC

Practice location

Address: 360 Freemont Rd, Longs, SC 29568-8303
Phone: (405) 669-7170

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence 11875 (OK)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in South Carolina →

Registry record

NPI: 1538918016
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 May 2024
Record last updated: 16 May 2024

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.