# COLLABORATIVE & INNOVATED CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114752409
- **Authorized official:** ELA CLARIDA (OWNER)
- **Authorized official phone:** (843) 222-5395

## Contact information

- **Practice address:** 1016 2ND AVE N STE 203A, NORTH MYRTLE BEACH, SC 29582-3288
- **Practice address phone:** (843) 222-5395
- **Practice address fax:** (866) 340-0296
- **Mailing address:** 1016 2ND AVE N STE 203A, NORTH MYRTLE BEACH, SC 29582-3288
- **Mailing address phone:** (843) 222-5395
- **Mailing address fax:** (866) 340-0296

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/05/2024
- **Last updated:** 09/29/2024