Healthcare Provider Details

I. General information

NPI: 1306822127
Provider Name (Legal Business Name): SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 DUTCH SQUARE BLVD
COLUMBIA SC
29210-7317
US

IV. Provider business mailing address

10100 ELIDA RD
DELPHOS OH
45833-9056
US

V. Phone/Fax

Practice location:
  • Phone: 803-791-7328
  • Fax: 803-791-4198
Mailing address:
  • Phone: 419-695-8010
  • Fax: 419-695-0565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberSR-0009100001-CPA
License Number StateSC

VIII. Authorized Official

Name: LISA SCHULTE
Title or Position: JR ACCOUNTANT
Credential:
Phone: 419-695-8010