Provider Demographics
NPI:1104998673
Name:CHERYL GAJADHAR
Entity type:Organization
Organization Name:CHERYL GAJADHAR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:GAJADHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-754-6764
Mailing Address - Street 1:3830 DAVIES DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-4709
Mailing Address - Country:US
Mailing Address - Phone:803-754-6764
Mailing Address - Fax:803-691-1137
Practice Address - Street 1:3830 DAVIES DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-4709
Practice Address - Country:US
Practice Address - Phone:803-754-6764
Practice Address - Fax:803-691-1137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC058206-6251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services