Provider Demographics
NPI:1023302536
Name:GOLDEN RULE ENHANCED PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:GOLDEN RULE ENHANCED PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SIMONA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-367-8880
Mailing Address - Street 1:8319 COZEN WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-7318
Mailing Address - Country:US
Mailing Address - Phone:843-367-8880
Mailing Address - Fax:
Practice Address - Street 1:1072 KING ST
Practice Address - Street 2:SUITE D
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-3794
Practice Address - Country:US
Practice Address - Phone:843-367-8880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health