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General NPI Number Information
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NPI Number | 1609137967
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Entity Type | Organization
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Legal Business Name | THORNWELL
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Dates
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Enumeration Date | 06/04/2012
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 302 S BROAD ST
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City | CLINTON
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State | SC
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Zip | 29325-2507
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Country | US
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Telephone | 864-938-2100
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Fax | 864-938-2122
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Provider Business Mailing Address
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Address Line | 302 S BROAD ST
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City | CLINTON
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State | SC
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Zip | 29325-2507
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Country | US
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Telephone | 864-938-2100
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Fax | 864-938-2122
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Authorized Official
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Title or Position | VICE PRESIDENT OF PROGRAMS
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Name | MORGAN EDNIE
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Credential |
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Telephone | 864-923-5998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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