Healthcare Provider Details

I. General information

NPI: 1699007021
Provider Name (Legal Business Name): SOUTHWEST CAROLINA TREATMENT CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 BROADBENT WAY
ANDERSON SC
29625-1521
US

IV. Provider business mailing address

3523 PELHAM RD STE C
GREENVILLE SC
29615-4191
US

V. Phone/Fax

Practice location:
  • Phone: 864-222-9798
  • Fax: 864-222-9812
Mailing address:
  • Phone: 864-527-1250
  • Fax: 864-203-2066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6340
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberOTPN-049
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOY BAILLEY
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 864-527-1250