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General NPI Number Information
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NPI Number | 1912250150
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Entity Type | Organization
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Legal Business Name | OFFICE OF THE GOVERNOR CONTINUUM OF CARE
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 1205 PENDLETON ST SUITE 372
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City | COLUMBIA
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State | SC
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Zip | 29201-3756
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Country | US
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Telephone | 803-734-4500
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Fax | 803-734-4538
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Provider Business Mailing Address
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Address Line | 1205 PENDLETON ST SUITE 372
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City | COLUMBIA
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State | SC
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Zip | 29201-3756
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Country | US
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Telephone | 803-734-4500
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Fax | 803-734-4538
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SHELLEY A MCGEORGE
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Credential | PH.D.,MPA,LPC/S,LMFT
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Telephone | 803-734-4531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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