Healthcare Provider Details

I. General information

NPI: 1447543269
Provider Name (Legal Business Name): COLUMBIA AREA MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2011
Last Update Date: 05/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2715 COLONIAL DR
COLUMBIA SC
29203-6818
US

IV. Provider business mailing address

2715 COLONIAL DR
COLUMBIA SC
29203-6818
US

V. Phone/Fax

Practice location:
  • Phone: 803-898-4800
  • Fax: 803-898-0123
Mailing address:
  • Phone: 803-898-4800
  • Fax: 803-898-0123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number StateSC

VIII. Authorized Official

Name: MRS. JANET DENISE MINTON
Title or Position: HEALTH CARE COORDINATOR
Credential: MSW
Phone: 803-898-4870