| Reciprocate1906, Llc | |
|
4611 Hard Scrabble Rd Columbia SC 29229-8584 | |
| (954) 496-5641 | |
| Not Available |
| Full Name | Reciprocate1906, Llc |
|---|---|
| Speciality | Case Management |
| Location | 4611 Hard Scrabble Rd, Columbia, South Carolina |
| Authorized Official Name and Position | Dustin Gollopp (CEO) |
| Authorized Official Contact | 9544965641 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reciprocate1906, Llc 4611 Hard Scrabble Rd Columbia SC 29229-8584 Ph: (954) 496-5641 | Reciprocate1906, Llc 4611 Hard Scrabble Rd Columbia SC 29229-8584 Ph: (954) 496-5641 |
| NPI Number | 1255732871 |
|---|---|
| Provider Enumeration Date | 09/15/2014 |
| Last Update Date | 09/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255732871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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