Sc Dept Of Disabilities & Special Needs
Intermediate Care Facility, Intellectual Disabilities in Columbia, SC. Organization (NPI-2).
NPI number1104989060
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1104989060
- Entity type
- Organization (NPI-2)
- Legal business name
- Sc Dept Of Disabilities & Special Needs
- Organization subpart
- No
- Enumeration date
- Dec 19, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 315P00000X | Intermediate Care Facility, Intellectual Disabilities | – | – | Yes |
Other names
- Oak Grove Community Residence (Other Name)
Practice location
3440 Harden Street ExtensionColumbia, SC 29203
Phone 803-898-9600 · Fax 803-898-9653
Mailing address
Po Box 4706Columbia, SC 29240-4706
Phone 803-898-9600 · Fax 803-898-9653
Authorized official
Robert William Barfield
Deputy State Director Administratio
8038989743
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All 105 Intellectual Disabilities Intermediate Care Facility providers in Columbia · All 14,701 providers in Columbia
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