Healthcare Provider Details

I. General information

NPI: 1952329153
Provider Name (Legal Business Name): SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTH ACCOUNTING OFFICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2715 COLONIAL DR
COLUMBIA SC
29203-6818
US

IV. Provider business mailing address

PO BOX 4440
COLUMBIA SC
29240-4440
US

V. Phone/Fax

Practice location:
  • Phone: 803-898-4880
  • Fax: 803-898-4899
Mailing address:
  • Phone: 803-898-4880
  • Fax: 803-898-4899

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 K TURNER
Title or Position: CONTROLLER
Credential:
Phone: 803-898-8503