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General NPI Number Information
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NPI Number | 1285637785
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Entity Type | Organization
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Legal Business Name | EASTER SEAL SOCIETY OF SOUTH CAROLINA INC
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 12/21/2022
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Provider Practice Location Address
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Address Line | 101 DEER RUN RD
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City | ELGIN
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State | SC
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Zip | 29045-8605
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Country | US
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Telephone | 803-422-3894
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Fax | 803-888-4382
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Provider Business Mailing Address
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Address Line | 101 DEER RUN RD
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City | ELGIN
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State | SC
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Zip | 29045-8605
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Country | US
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Telephone | 803-422-3894
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Fax | 803-661-8450
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Authorized Official
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Title or Position | CENTER MANAGER
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Name | SHAE PEAK
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Credential | CHE
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Telephone | 803-212-8971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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