Provider Demographics
NPI:1225375793
Name:A TEAM HEALTHCARE SERVICES
Entity type:Organization
Organization Name:A TEAM HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:URSHULA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-361-5249
Mailing Address - Street 1:PO BOX 50232
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29250-0232
Mailing Address - Country:US
Mailing Address - Phone:803-361-5249
Mailing Address - Fax:
Practice Address - Street 1:3935 SUNSET BLVD
Practice Address - Street 2:STE. G.
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-2403
Practice Address - Country:US
Practice Address - Phone:803-796-9612
Practice Address - Fax:803-796-9615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC85573251B00000X, 251C00000X, 251S00000X, 253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care Agency