Organization
LYFE INTERVENTION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARIUS DURAND LAGROON BS (CEO)
(864) 862-6912
Entity
Organization
Contact information
Practice address
401 PUTMAN STREET, FOUNTAIN INN, SC 29644
(864) 862-6912
Mailing address
401 PUTMAN STREET, FOUNTAIN INN, SC 29644
(864) 862-6912
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
251S00000X
SC
Other
Enumeration date
12/28/2011
Last updated
12/28/2011
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