Organization
GIVEBAC INCORPORATED
Active
Other names
Ace Camp
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY LYNN MCLAIN CACII (TREATMENT DIRECTOR)
(843) 623-3077
Entity
Organization
Contact information
Practice address
1481 TED MELTON RD, CHESTERFIELD, SC 29709-6313
(843) 623-3077
(843) 623-3077
Mailing address
1481 TED MELTON RD, PO BOX 347, CHESTERFIELD, SC 29709-6313
(843) 623-3077
(843) 623-3077
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
OTP-002
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CBT015
—
SC
Enumeration date
02/28/2008
Last updated
02/28/2008
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