Healthcare Provider Details

I. General information

NPI: 1770542540
Provider Name (Legal Business Name): ADVANCE BEHAVIORAL MEDICINE. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 CRANIUM DR STE 101
ROCK HILL SC
29732-3552
US

IV. Provider business mailing address

PO BOX 36624
ROCK HILL SC
29732-0510
US

V. Phone/Fax

Practice location:
  • Phone: 803-327-4357
  • Fax: 803-324-4357
Mailing address:
  • Phone: 803-327-4357
  • Fax: 803-324-4357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number22946
License Number StateSC

VIII. Authorized Official

Name: DR. DELFIN VALITE
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 803-327-4357