| Corleone Enterprises Incorporated | |
|
130 Wilkshire Dr Columbia SC 29210-4254 | |
| (704) 665-8213 | |
| Not Available |
| Full Name | Corleone Enterprises Incorporated |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 130 Wilkshire Dr, Columbia, South Carolina |
| Authorized Official Name and Position | John Henry Stephens (OWNER) |
| Authorized Official Contact | 7046658213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Corleone Enterprises Incorporated 130 Wilkshire Dr Columbia SC 29210-4254 Ph: (704) 665-8213 | Corleone Enterprises Incorporated 130 Wilkshire Dr Columbia SC 29210-4254 Ph: (704) 665-8213 |
| NPI Number | 1548087612 |
|---|---|
| Provider Enumeration Date | 09/20/2024 |
| Last Update Date | 09/20/2024 |
| Certification Date | 09/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548087612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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