Provider Demographics
NPI:1467485524
Name:CHARIS CENTER-SOUTH, INC.
Entity Type:Organization
Organization Name:CHARIS CENTER-SOUTH, INC.
Other - Org Name:CHARIS COUNSELING CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:KENYON
Authorized Official - Last Name:SWEITZER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:508-947-1901
Mailing Address - Street 1:6 PLYMPTON ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1602
Mailing Address - Country:US
Mailing Address - Phone:508-947-1901
Mailing Address - Fax:508-923-3462
Practice Address - Street 1:6 PLYMPTON ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1602
Practice Address - Country:US
Practice Address - Phone:508-947-1901
Practice Address - Fax:508-923-3462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MACHW40035Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER