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General NPI Number Information
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NPI Number | 1255703575
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Entity Type | Organization
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Legal Business Name | OPTIONS FOR SOCIAL CHANGE, LLC
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 2145 DORCHESTER RD
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City | N CHARLESTON
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State | SC
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Zip | 29405-7763
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Country | US
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Telephone | 843-343-4188
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Fax |
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Provider Business Mailing Address
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Address Line | 2396 ERSKINE AVE
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City | CHARLESTON
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State | SC
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Zip | 29414-7004
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Country | US
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Telephone | 843-343-4188
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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 | MS. SHIRLEY FORD
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Credential | MSW, LISW CP/AP
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Telephone | 843-343-4188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | SC 1449
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License Number State | SC
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