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Mr. Wayne Chavis
Physical Disabilities Residential Treatment Facility in Fort Mill, South Carolina
NPI 1417497314

Wayne Chavis is a Physical Disabilities Residential Treatment Facility based in Fort Mill, SC. Wayne Chavis practices in Fort Mill, SC. The NPI Number for Wayne Chavis is 1417497314 and holds a License No. 364SHO200X (South Carolina).

The current practice location address for Wayne Chavis is 7223 Kendallwood Ct, Fort Mill, SC and can be reached out via phone at 803-357-1105.

Location: 7223 Kendallwood Ct, Fort Mill, SC, 29715-6219
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417497314
Provider Name
Wayne Chavis
Credential
Provider Entity Type
Individual
Gender
Male
Address
7223 Kendallwood Ct, Fort Mill, SC, 29715-6219
Phone Number
803-357-1105
Fax Number
Provider Enumeration Date
02/27/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
364SHO200X 05 SC
institution
Provider Business Practice Location Address Details
Address
7223 Kendallwood Ct
City
Fort Mill
State
South Carolina
Zip
29715-6219
Phone Number
803-357-1105
Fax Number
person
Provider Business Mailing Address Details
Address
7223 Kendallwood Ct
City
Fort Mill
State
South Carolina
Zip
29715-6219
Phone Number
803-357-1105
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Physical Disabilities
Speciality
-
Taxonomy
320700000X
License No.
364SHO200X (South Carolina)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
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