Healthcare Provider Details

I. General information

NPI: 1184826380
Provider Name (Legal Business Name): YORK COUNTY BOARD OF DISABILITIES & SPECIAL NEEDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 PARK PLACE RD
YORK SC
29745-7476
US

IV. Provider business mailing address

PO BOX 549
YORK SC
29745-0549
US

V. Phone/Fax

Practice location:
  • Phone: 803-628-5999
  • Fax: 803-628-7984
Mailing address:
  • Phone: 803-628-5999
  • Fax: 803-628-7984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number73284
License Number StateSC

VIII. Authorized Official

Name: MICHELLE NORRIS SHAFFER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 803-818-6752