Provider Demographics
NPI:1871130252
Name:DISCOVERY CENTER FOR LIFE SKILLS, LLC
Entity type:Organization
Organization Name:DISCOVERY CENTER FOR LIFE SKILLS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:HARBIN
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP
Authorized Official - Phone:864-760-4089
Mailing Address - Street 1:2315 N MAIN ST STE 209
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-3880
Mailing Address - Country:US
Mailing Address - Phone:864-760-4089
Mailing Address - Fax:800-340-0223
Practice Address - Street 1:2315 N MAIN ST STE 209
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-3880
Practice Address - Country:US
Practice Address - Phone:864-760-4089
Practice Address - Fax:800-340-0223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)