Healthcare Provider Details

I. General information

NPI: 1316904857
Provider Name (Legal Business Name): SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 11/04/2020
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 GREGG HWY
AIKEN SC
29801-6341
US

IV. Provider business mailing address

1135 GREGG HWY
AIKEN SC
29801-6341
US

V. Phone/Fax

Practice location:
  • Phone: 803-641-7700
  • Fax: 803-641-7709
Mailing address:
  • Phone: 803-641-7700
  • Fax: 803-641-7709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TRACY L TURNER
Title or Position: CONTROLLER
Credential:
Phone: 803-898-8503