Provider Demographics
NPI:1033406665
Name:FAMILY MATTERS OF THE PEE DEE
Entity Type:Organization
Organization Name:FAMILY MATTERS OF THE PEE DEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HYATT
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:843-616-0296
Mailing Address - Street 1:PO BOX 447
Mailing Address - Street 2:
Mailing Address - City:LATTA
Mailing Address - State:SC
Mailing Address - Zip Code:29565-0447
Mailing Address - Country:US
Mailing Address - Phone:843-616-0296
Mailing Address - Fax:
Practice Address - Street 1:273 HATTIE LN
Practice Address - Street 2:
Practice Address - City:LATTA
Practice Address - State:SC
Practice Address - Zip Code:29565-4160
Practice Address - Country:US
Practice Address - Phone:843-616-0296
Practice Address - Fax:843-536-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-04
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9799251S00000X
251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable