Provider Demographics
NPI:1437569662
Name:COMMUNITIES IN SCHOOLS OF THE CHARLESTON AREA, INC.
Entity Type:Organization
Organization Name:COMMUNITIES IN SCHOOLS OF THE CHARLESTON AREA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-740-6793
Mailing Address - Street 1:1090 EAST MONTAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405
Mailing Address - Country:US
Mailing Address - Phone:843-740-6793
Mailing Address - Fax:843-740-6797
Practice Address - Street 1:1090 E MONTAGUE AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-4837
Practice Address - Country:US
Practice Address - Phone:843-740-6793
Practice Address - Fax:843-740-6797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health