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General NPI Number Information
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NPI Number | 1992007355
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Entity Type | Organization
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Legal Business Name | COURTLYN HOUSE CRCF
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Dates
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Enumeration Date | 11/17/2010
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Last Update Date | 11/17/2010
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Provider Practice Location Address
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Address Line | 10508 GARNERS FERRY RD
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City | EASTOVER
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State | SC
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Zip | 29044-9352
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Country | US
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Telephone | 803-695-2158
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Fax | 803-695-2746
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Provider Business Mailing Address
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Address Line | 10508 GARNERS FERRY RD
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City | EASTOVER
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State | SC
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Zip | 29044-9352
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Country | US
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Telephone | 803-695-2158
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Fax | 803-695-2746
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | ANN J. FINDLEY
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Credential |
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Telephone | 803-695-2158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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