Healthcare Provider Details

I. General information

NPI: 1497784276
Provider Name (Legal Business Name): ORIN COMMUNITY HEALTH CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 S CHURCH ST
SPARTANBURG SC
29306-5345
US

IV. Provider business mailing address

113 BITTERNUT LN
TAYLORS SC
29687-5865
US

V. Phone/Fax

Practice location:
  • Phone: 864-230-6479
  • Fax: 864-578-7176
Mailing address:
  • Phone: 864-230-6479
  • Fax: 864-578-7176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4714
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number4714
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number4714
License Number StateSC

VIII. Authorized Official

Name: DERRICK LAVON HIGHTOWER
Title or Position: EXECUTIVE DIRECTOR/CFO
Credential: LPCI
Phone: 864-230-6479