Lyfe Intervention Services
NPI #1164791778 in Fountain Inn, South Carolina
Provider Information
- NPI Number
- 1164791778
- Entity Type
- Organization
- Organization Name
- Lyfe Intervention Services
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Dec 28, 2011
- Last Updated
- Dec 28, 2011
Practice Location
- Address
- 401 PUTMAN STREET
- City
- Fountain Inn
- State
- South Carolina
- ZIP Code
- 29644
- Phone
- (864) 862-6912
Authorized Official
- Name
- MR. DARIUS DURAND LAGROON, BS
- Title
- CEO
- Phone
- (864) 862-6912
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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