Provider Demographics
NPI:1386022788
Name:HEALTH CENTERS AT LAURENS, LLC
Entity Type:Organization
Organization Name:HEALTH CENTERS AT LAURENS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-984-5522
Mailing Address - Street 1:1113 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-2609
Mailing Address - Country:US
Mailing Address - Phone:864-984-5522
Mailing Address - Fax:864-752-1036
Practice Address - Street 1:1113 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-2609
Practice Address - Country:US
Practice Address - Phone:864-984-5522
Practice Address - Fax:864-752-1036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty