Provider Demographics
NPI:1992753578
Name:SOUTH CAROLINA SCHOOL FOR THE DEAF AND THE BLIND
Entity type:Organization
Organization Name:SOUTH CAROLINA SCHOOL FOR THE DEAF AND THE BLIND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:SANDERSON
Authorized Official - Last Name:BREITWEISER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:864-577-7500
Mailing Address - Street 1:355 CEDAR SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-4628
Mailing Address - Country:US
Mailing Address - Phone:864-585-7711
Mailing Address - Fax:864-585-3555
Practice Address - Street 1:355 CEDAR SPRINGS RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-4628
Practice Address - Country:US
Practice Address - Phone:864-585-7711
Practice Address - Fax:864-585-3555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
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
SCSDB001Medicaid