Provider Demographics
NPI:1336414515
Name:ROCK HILL BEHAVIORAL, LLC
Entity Type:Organization
Organization Name:ROCK HILL BEHAVIORAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:GARCIA-ESQUERRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-542-8012
Mailing Address - Street 1:125 HAMPTON ST
Mailing Address - Street 2:#300
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-4590
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 HAMPTON ST
Practice Address - Street 2:#300
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-4590
Practice Address - Country:US
Practice Address - Phone:803-712-4555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)