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General NPI Number Information
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NPI Number | 1235502808
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Entity Type | Organization
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Legal Business Name | COMMUNITY INITIATIVES, INC.
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Dates
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Enumeration Date | 11/04/2015
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Last Update Date | 11/04/2015
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Provider Practice Location Address
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Address Line | 929 PHOENIX ST
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City | GREENWOOD
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State | SC
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Zip | 29646-3248
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Country | US
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Telephone | 864-941-7980
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Fax | 864-229-7016
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Provider Business Mailing Address
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Address Line | 201 CHURCH AVE
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City | GREENWOOD
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State | SC
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Zip | 29646-4583
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TERESA GOODMAN
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Credential |
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Telephone | 864-223-7472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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