Organization
PATTISONS D R E A M ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA GANCI (EXECUTIVE DIRECTOR)
(843) 402-7850
Entity
Organization
Contact information
Practice address
721 WAPPOO RD, CHARLESTON, SC 29407-5861
(843) 402-7850
(843) 402-7850
Mailing address
PO BOX 80426, CHARLESTON, SC 29416-0426
(843) 402-7850
(843) 402-7851
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4825-1861678535
—
SC
Enumeration date
01/12/2008
Last updated
10/26/2023
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