Healthcare Provider Details
I. General information
NPI: 1316459811
Provider Name (Legal Business Name): TURNING POINT BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2017
Last Update Date: 10/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1107 BELLEVIEW ST
COLUMBIA SC
29201-1810
US
IV. Provider business mailing address
53 DOTTS RD
SALTERS SC
29590-3169
US
V. Phone/Fax
- Phone: 803-446-5780
- Fax:
- Phone: 803-477-7928
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SHAKA
ABDUL
MOUSTAFA-I
I
Title or Position: CEO/OWNER
Credential: PH.D
Phone: 803-446-5780