Organization · Type 2 NPI

Individual

Emotionally Disturbed Childrens' Residential Treatment Facility · Columbia, SC

NPI number 1639415920 Active

Practice location

1725 Shivers Rd
Columbia, SC 29210-5413

Call (803) 896-5732 Map

Fax (803) 896-5723

Specialties and licenses

TaxonomyCodeLicense
Emotionally Disturbed Childrens' Residential Treatment Facility Primary 322D00000X5322 (SC)

Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

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About NPI 1639415920

Individual's National Provider Identifier is 1639415920, issued on Dec 14, 2012. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Columbia, SC. The record was last updated on Dec 14, 2012.