Healthcare Provider Details

I. General information

NPI: 1508135112
Provider Name (Legal Business Name): SOCIAL SERVICE COMPLIANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2011
Last Update Date: 12/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 FOXHOUND CT
SIMPSONVILLE SC
29680-6710
US

IV. Provider business mailing address

603 FOXHOUND CT
SIMPSONVILLE SC
29680-6710
US

V. Phone/Fax

Practice location:
  • Phone: 864-230-5475
  • Fax: 864-963-8291
Mailing address:
  • Phone: 864-230-5475
  • Fax: 864-963-8291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number4817
License Number StateSC

VIII. Authorized Official

Name: MRS. TARA B. ALLEN
Title or Position: OWNER
Credential: LISW-CP/AP
Phone: 864-230-5475