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COLLABORATIVE & INNOVATED CARE
NPI 1114752409
Clinic/Center - Multi-Specialty in North Myrtle Beach, SC

Active since September 05, 2024
1016 2ND AVE N STE 203A, NORTH MYRTLE BEACH, SC 29582(843) 222-5395(866) 340-0296 Get Directions Write a Review

NPPES record last updated: September 29, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 29, 2024, Sep 5, 2024 (2 updates tracked since 2024).

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Authorized Official
  4. Frequently Asked Questions
  • Organization
  • Clinic/Center
  • Multi-Specialty

About COLLABORATIVE & INNOVATED CARE

This page provides the complete NPI Profile along with additional information for Collaborative & Innovated Care, a provider established in North Myrtle Beach, South Carolina operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1114752409 assigned on September 2024. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Ela Clarida (Owner)

NPI
1114752409 Verify this NPI
Provider Name
COLLABORATIVE & INNOVATED CARE
Entity Type
Organization
Location Address
1016 2ND AVE N STE 203A NORTH MYRTLE BEACH, SC 29582
Location Phone
(843) 222-5395
Location Fax
(866) 340-0296
Mailing Address
1016 2ND AVE N STE 203A NORTH MYRTLE BEACH, SC 29582
Mailing Phone
(843) 222-5395
Mailing Fax
(866) 340-0296
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-05-2024
Last Update Date
09-29-2024
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Multi-Specialty

Taxonomy Code
261QM1300X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ELA CLARIDA

Authorized Official Title
OWNER
Authorized Official Phone
(843) 222-5395

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Frequently Asked Questions

What is COLLABORATIVE & INNOVATED CARE's NPI number?

The NPI number assigned to this healthcare provider is 1114752409, enumerated as an "organization" on September 05, 2024.

Where is the provider located?

The provider is located at 1016 2ND AVE N STE 203A NORTH MYRTLE BEACH, SC 29582 and the phone number is (843) 222-5395.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.