Provider Demographics
NPI:1568476885
Name:SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
Entity type:Organization
Organization Name:SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-898-8503
Mailing Address - Street 1:448 LAKESHORE PKWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-4264
Mailing Address - Country:US
Mailing Address - Phone:803-328-9600
Mailing Address - Fax:803-329-7141
Practice Address - Street 1:448 LAKESHORE PKWY
Practice Address - Street 2:SUITE 205
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-4264
Practice Address - Country:US
Practice Address - Phone:803-328-9600
Practice Address - Fax:803-329-7141
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-29
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC342725Medicaid
SC3339Medicare PIN