Lantana Recovery
Clinic/Center, Rehabilitation, Substance Use Disorder in Charleston, SC. Organization (NPI-2).
NPI number1801431069
StatusActive
Last updated in NPPESJul 31, 2021
Details
- NPI
- 1801431069
- Entity type
- Organization (NPI-2)
- Legal business name
- Lantana Recovery
- Organization subpart
- No
- Enumeration date
- Nov 12, 2019
- Certification date
- Jul 31, 2021
- Last updated
- Jul 31, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – | Yes |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – |
Practice location
65 Gadsden StCharleston, SC 29401-1145
Phone 314-603-3492
Mailing address
65 Gadsden StCharleston, SC 29401-1145
Authorized official
Warren Phillips
Owner
3146033492
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