1528041266 NPI number — NEW FOUNDATIONS CHILDREN AND FAMILY SERVICES, INC.

Table of content: (NPI 1528041266)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528041266 NPI number — NEW FOUNDATIONS CHILDREN AND FAMILY SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW FOUNDATIONS CHILDREN AND FAMILY SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ANDERSON YOUTH ASSOCIATION
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528041266
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2300 STANDRIDGE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANDERSON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29625-3211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-225-1628
Provider Business Mailing Address Fax Number:
864-260-4699

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2300 STANDRIDGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANDERSON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29625-3211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-225-1628
Provider Business Practice Location Address Fax Number:
864-260-4699
Provider Enumeration Date:
11/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HARRINGTON
Authorized Official First Name:
DONNA
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
FINANCE MANAGER
Authorized Official Telephone Number:
864-225-1628

Provider Taxonomy Codes

  • Taxonomy code: 322D00000X , with the licence number:  SR-0008145001-CCI , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 322D00000X , with the licence number: SR-0008152001-CCI , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 322D00000X , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 322D00000X , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: GP1385 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 994MXH , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: CBT016 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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