Organization
RECIPROCATE1906, LLC
Active
Parent organization
RECIPROCATE1906, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
RECIPROCATE1906, LLC
Authorized official
DUSTIN GOLLOPP (CEO)
(954) 496-5641
Entity
Organization
Contact information
Practice address
4611 HARD SCRABBLE RD, COLUMBIA, SC 29229-8584
(954) 496-5641
Mailing address
4611 HARD SCRABBLE RD, COLUMBIA, SC 29229-8584
(954) 496-5641
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
09/15/2014
Last updated
09/15/2014
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