Healthcare Provider Details
I. General information
NPI: 1104479971
Provider Name (Legal Business Name): CURASIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2019
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
890 MILL ST STE 102
RENO NV
89502-1470
US
IV. Provider business mailing address
700 PLAZA CIR STE N
CLINTON SC
29325-7556
US
V. Phone/Fax
- Phone: 775-870-1566
- Fax: 775-301-6653
- Phone: 864-547-2160
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GAIL
A
WILSON
Title or Position: BILLING ADMINISTRATOR
Credential:
Phone: 864-878-1528