NPI 1568114957

General Council on Finance & Admins

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Irmo, SC

Practice location

Address: 401 Western Ln STE 6, Irmo, SC 29063-7953
Phone: (843) 754-8936
Mailing address: PO Box 203, Ballentine, SC 29002-0203

Authorised official

Name: Elaine Mathis
Title: Executive Director
Phone: (843) 754-8936

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in South Carolina →

Registry record

NPI: 1568114957
Entity type: Organization
NPI issued: 26 Jan 2022
Record last updated: 26 Jan 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.