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CAROLINA FAMILY SERVICES OF GREENVILLE LLC NPI 1073761870


NPI Information

NPI: 1073761870
Provider Name: CAROLINA FAMILY SERVICES OF GREENVILLE LLC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 42D2273029

Address:
17 MEMORIAL MEDICAL DRIVE
GREENVILLE, SC
ZIP 29605
Phone: (864) 283-0637
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CAROLINA FAMILY SERVICES OF GREENVILLE LLC is a community behavioral health in Greenville, SC. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. CAROLINA FAMILY SERVICES OF GREENVILLE LLC NPI is 1073761870. The provider is registered as an organization entity type.

The provider's business location address is:

17 MEMORIAL MEDICAL DRIVE
GREENVILLE, SC
ZIP 29605-407
Phone: (864) 283-0637
Fax: (864) 283-0638

The provider's authorized official is Jennifer L Brooks .
The authorized official title is Ceo and has the following contact phone number (864) 283-0637.

The CLIA number assigned to this NPI record is 42D2273029 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/4/2008 and was last updated on 11/16/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GP4952MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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