Provider Demographics
NPI:1386725620
Name:CLAENDON SCHOOL DISTRICT TWO OFFICE OF SPECIAL SERVICES
Entity type:Organization
Organization Name:CLAENDON SCHOOL DISTRICT TWO OFFICE OF SPECIAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELEASE
Authorized Official - Middle Name:
Authorized Official - Last Name:FULTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-435-8326
Mailing Address - Street 1:15 MAJOR DR
Mailing Address - Street 2:
Mailing Address - City:MANNING
Mailing Address - State:SC
Mailing Address - Zip Code:29102-3213
Mailing Address - Country:US
Mailing Address - Phone:803-435-8326
Mailing Address - Fax:
Practice Address - Street 1:15 MAJOR DR
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:SC
Practice Address - Zip Code:29102-3213
Practice Address - Country:US
Practice Address - Phone:803-435-8326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC936MXHMedicaid
SCSD1402OtherSTATE/SCHOOL PROVIDER ID