MEDICARE: SOLID FOUNDATIONS OF THE CAROLINAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1558723155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLID FOUNDATIONS OF THE CAROLINAS

Provider Business Mailing Address
First Line	:	7707 SAINT ANDREWS RD
Second Line	:
City	:	IRMO
State	:	SC
Zip	:	29063-2835
Country	:	US
Telephone Number	:	803-521-0070
Fax Number	:

Provider Business Practice Location Address
First Line	:	7707 SAINT ANDREWS RD
Second Line	:
City	:	IRMO
State	:	SC
Zip	:	29063-2835
Country	:	US
Telephone Number	:	803-521-0070
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LINDA LUANN HITER
Credential	:
Telephone Number	:	803-608-4288

Provider Enumeration Date	:	03/23/2016
Last Update Date	:	07/21/2016

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Directions to “SOLID FOUNDATIONS OF THE CAROLINAS ” Practice Location

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