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Contact Information

EARLY ADVANTAGE, LLC
1320 EDEN RD
AWENDAW, SC29429-5914
 Phone: 843-270-3567
 Fax: 843-856-4932
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

225XP0200X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for EARLY ADVANTAGE, LLC

NPI # 1912063660
LBN Legal business name EARLY ADVANTAGE, LLC
Authorized official BRENDA REAGAN - (OWNER,THERAPIST)
Entity Organization
Organization subpart 1 No
Enumeration date 12/28/2006
Last updated 11/19/2013 - About 13 years ago
Identifiers
SC License # 1498
SC Medicaid GP4022
SC Medicaid TH1465
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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