Provider Demographics
NPI:1518619147
Name:CAROLYNMICHAEL LIFESTYLE AND BUSINESS SERVICES, LLC
Entity Type:Organization
Organization Name:CAROLYNMICHAEL LIFESTYLE AND BUSINESS SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TALETA
Authorized Official - Middle Name:
Authorized Official - Last Name:FINKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-902-4795
Mailing Address - Street 1:2364 FREEDOM BLVD APT A8
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6096
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2516 E HIGHWAY 76
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:SC
Practice Address - Zip Code:29571-6348
Practice Address - Country:US
Practice Address - Phone:843-407-4526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNONE