Provider Demographics
NPI:1023617941
Name:THE PLACE OF HEALING
Entity type:Organization
Organization Name:THE PLACE OF HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANDRA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:KETTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-616-6072
Mailing Address - Street 1:PO BOX 443
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29540-0443
Mailing Address - Country:US
Mailing Address - Phone:843-944-5080
Mailing Address - Fax:843-944-5080
Practice Address - Street 1:712 PEARL ST
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-3842
Practice Address - Country:US
Practice Address - Phone:843-944-5080
Practice Address - Fax:843-944-5080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251X00000XAgenciesSupports Brokerage
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No251B00000XAgenciesCase Management