Organization
LIONS DEN RECREATION CENTER, THE
Active
Other names
Lions Den, The
Organization subpart
No
Provider details
NPI number
Authorized official
H. CRAIG JACKSON COTA/L (DIRECTOR OF REHABILITATION SERVICES)
(843) 819-9470
Entity
Organization
Contact information
Practice address
4159 DORCHESTER RD, SUITE B, NORTH CHARLESTON, SC 29405-7426
(843) 718-3064
(843) 718-3064
Mailing address
4159 DORCHESTER RD, SUITE B, NORTH CHARLESTON, SC 29405
(843) 718-3064
(843) 718-3064
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
981
SC
251V00000X
Voluntary or Charitable Agency
981
SC
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
981
SC
291U00000X
Clinical Medical Laboratory
981
SC
324500000X
Substance Abuse Rehabilitation Facility
Primary
981
SC
Other
Enumeration date
06/05/2015
Last updated
06/05/2015
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