Organization
864PRIDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA DAVIS LISW-CP (PRESIDENT)
(864) 325-1356
Entity
Organization
Contact information
Practice address
30 POINTE CIR, GREENVILLE, SC 29615-3506
(864) 655-5193
(864) 655-5183
Mailing address
30 POINTE CIR, GREENVILLE, SC 29615-3506
(864) 325-1356
(864) 655-5183
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/03/2023
Last updated
02/03/2023
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