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General NPI Number Information
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NPI Number | 1881384964
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Entity Type | Organization
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Legal Business Name | ZEN ZONE HEALTH LLC
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 500 OAKBROOK LN UNIT 201
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City | SUMMERVILLE
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State | SC
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Zip | 29485-8293
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Country | US
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Telephone | 843-970-0285
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Fax |
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Provider Business Mailing Address
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Address Line | 500 OLDBROOK LANE SUITE 201
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City | SUMMERVILLE
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State | SC
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Zip | 29485
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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 | COO
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Name | TOM J MCCUSKER
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Credential |
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Telephone | 843-970-0285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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