Provider Demographics
NPI:1699435974
Name:SOUTH CAROLINA AUTISM SOCIETY
Entity type:Organization
Organization Name:SOUTH CAROLINA AUTISM SOCIETY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-767-3547
Mailing Address - Street 1:806 12TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-6142
Mailing Address - Country:US
Mailing Address - Phone:803-750-6988
Mailing Address - Fax:803-750-8121
Practice Address - Street 1:806 12TH ST
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-6142
Practice Address - Country:US
Practice Address - Phone:803-750-6988
Practice Address - Fax:803-750-8121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management