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Organization
RECIPROCATE1906, LLC
Active
Organization
RECIPROCATE1906, LLC
Active
Parent organization
RECIPROCATE1906, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
RECIPROCATE1906, LLC
Authorized official
DUSTIN GOLLOPP (CEO)
(954) 496-5641
Entity
Organization
Contact information
Practice address
4611 HARD SCRABBLE RD, COLUMBIA, SC 29229-8584
(954) 496-5641
Mailing address
4611 HARD SCRABBLE RD, COLUMBIA, SC 29229-8584
(954) 496-5641
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
251B00000X
Case Management Agency
Primary
—
NULL
Other
Enumeration date
09/15/2014
Last updated
09/15/2014
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