| Sophron Space LLC | |
|
1418 Boker Rd Conway SC 29527-2905 | |
| (347) 520-8605 | |
| Not Available |
| Full Name | Sophron Space LLC |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1418 Boker Rd, Conway, South Carolina |
| Authorized Official Name and Position | Latricia Andrene Harvey (OWNER) |
| Authorized Official Contact | 3475208605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sophron Space LLC 1418 Boker Rd Conway SC 29527-2905 Ph: (347) 520-8605 | Sophron Space LLC 1418 Boker Rd Conway SC 29527-2905 Ph: (347) 520-8605 |
| NPI Number | 1295655892 |
|---|---|
| Provider Enumeration Date | 07/16/2026 |
| Last Update Date | 07/16/2026 |
| Certification Date | 07/16/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295655892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Primary |
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