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NPI Code Detail

MEDICARE: EPWORTH CHILDREN'S HOME

MEDICARE: EPWORTH CHILDREN'S HOME
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2261QM0855XAdolescent and Children Mental Health Clinic/Center
3385HR2055XChild Mental Illness Respite Care
4253J00000XFoster Care Agency

General Provider Information

NPI Number : 1952947848
Entity Type Code : Organization
Provider Name (Legal Business Name) : EPWORTH CHILDREN'S HOME
Provider Business Mailing Address
First Line : PO BOX 50466
Second Line :
City : COLUMBIA
State : SC
Zip : 29250-0466
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3201 TRENHOLM RD
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-3371
Country : US
Telephone Number : 803-256-7394
Fax Number :
Authorized Official
Title or Position : HR ADMIN ASSISTANT
Name : TEDDI T GARRICK
Credential :
Telephone Number : 803-256-7394
Provider Enumeration Date : 11/26/2019
Last Update Date : 11/26/2019

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Directions to “EPWORTH CHILDREN'S HOME ” Practice Location

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