Healthcare Provider Details
I. General information
NPI: 1841528551
Provider Name (Legal Business Name): MVRUGEABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/19/2009
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1456 PINE ISLAND VIEW
MT PLEASANT SC
29464-3838
US
IV. Provider business mailing address
1456 PINE ISLAND VIEW
MT PLEASANT SC
29464-3838
US
V. Phone/Fax
- Phone: 843-343-8875
- Fax:
- Phone: 843-343-8875
- Fax: 843-546-0412
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-09-5328 |
| License Number State | |
VIII. Authorized Official
Name: MRS.
MELISSA
VALENTINE
RUGE
Title or Position: OWNER, DIRECTOR
Credential: BCBA
Phone: 843-343-8875