Healthcare Provider Details

I. General information

NPI: 1932393881
Provider Name (Legal Business Name): COMMUNITY CARE OF YORK COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 09/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1085 HEARN ST APT G
ROCK HILL SC
29732-2635
US

IV. Provider business mailing address

1085 HEARN ST APT G
ROCK HILL SC
29732-2635
US

V. Phone/Fax

Practice location:
  • Phone: 803-448-8417
  • Fax: 803-324-9117
Mailing address:
  • Phone: 803-448-8417
  • Fax: 803-324-9117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOSEPHINE HENRY DOGAN
Title or Position: OWNER
Credential: BSW
Phone: 803-448-8417