| Shoreline Behavioral Health Services | |
|
2404 Wise Rd Conway SC 29526-5521 | |
| (843) 365-8884 | |
| (843) 365-6697 |
| Full Name | Shoreline Behavioral Health Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2404 Wise Rd, Conway, South Carolina |
| Authorized Official Name and Position | John F Coffin (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8343658884 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoreline Behavioral Health Services 2404 Wise Rd Conway SC 29526-5521 Ph: (843) 365-8884 | Shoreline Behavioral Health Services 2404 Wise Rd Conway SC 29526-5521 Ph: (843) 365-8884 |
| NPI Number | 1134158231 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 05/30/2023 |
| Certification Date | 05/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134158231 | NPI | - | NPPES |
| AD26HR | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | OTP-016 (South Carolina) | Secondary |
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