IndividualActive
Vanisha Bennett
NPI 1508481607 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Greenville, SC
Provider details
- NPI number
- 1508481607
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
305 Shada Ln
Greenville, SC 29611-2068
Phone: (864) 887-6650
Approximate (ZIP-level) locationGet directions
Mailing address
305 Shada Ln
Greenville, SC 29611-2068
Registry dates
- Enumerated
- 2020-06-15
- Last updated
- 2020-06-15
- Certified
- 2020-06-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.