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General NPI Number Information
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NPI Number | 1912577982
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Entity Type | Organization
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Legal Business Name | THE FAMILY CENTER OF AIKEN COUNTY
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 1117 GEORGIA AVE
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-3012
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Country | US
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Telephone | 803-752-0404
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Fax | 888-384-2250
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Provider Business Mailing Address
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Address Line | 1117 GEORGIA AVE
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-3012
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Country | US
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Telephone | 803-752-0404
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Fax | 888-384-2250
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Authorized Official
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Title or Position | CEO/CLINICAL DIRECTOR
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Name | DR. EDGAR JOE HOLT
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Credential | PHD
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Telephone | 803-752-0404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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