Organization
UPSTATE ADHD CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA SAMAKE DNP, PMHNP-BC, APRN (PRESIDENT/CEO)
(864) 714-5637
Entity
Organization
Contact information
Practice address
300 JOHN ST UNIT 5B, GREER, SC 29651-1463
(864) 714-5637
Mailing address
PO BOX 25472, GREENVILLE, SC 29616-0472
(864) 714-5637
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/11/2021
Last updated
10/11/2023
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