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Organization
FYREBIRD RECOVERY
Active
Organization
FYREBIRD RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AZHANE POWELL LISW-CP (EXECUTIVE DIRECTOR)
(518) 375-0904
Entity
Organization
Contact information
Practice address
4924 HIGHWAY 17 BYP S UNIT J, MYRTLE BEACH, SC 29588-1605
(843) 691-0074
Mailing address
4924 HIGHWAY 17 BYP S UNIT J, MYRTLE BEACH, SC 29588-1605
(843) 691-0074
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/18/2026
Last updated
07/18/2026
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