| NPI | 1679930184 |
|---|---|
| Doing Business As | TIDEHAVEN HEALTH |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH C GRUENEBERGER Owner 843-971-8808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: SC 31920) | |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2022-05-05 |