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General NPI Number Information
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NPI Number | 1285280396
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Entity Type | Organization
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Legal Business Name | ACHIEVE BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 81 POINTE CIR STE A
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City | GREENVILLE
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State | SC
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Zip | 29615-3505
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Country | US
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Telephone | 803-622-5088
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Fax |
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Provider Business Mailing Address
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Address Line | 81 POINTE CIR STE A
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City | GREENVILLE
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State | SC
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Zip | 29615-3505
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | PATRICK HOGAN
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Credential |
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Telephone | 803-622-5088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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