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Organization
A SUCCESS STORY
Active
Organization
A SUCCESS STORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMIAN JERARD EDWARDS (PRESIDENT)
(864) 906-6645
Entity
Organization
Contact information
Practice address
25 FLEETWOOD DR, GREENVILLE, SC 29605-1510
(864) 906-6645
Mailing address
10 FLEETWOOD DR, GREENVILLE, SC 29605-1511
(864) 906-6645
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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