1215329750 NPI number — ABA AUTISM SERVICES OF SOUTH CAROLINA, LLP

Table of content: (NPI 1215329750)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215329750 NPI number — ABA AUTISM SERVICES OF SOUTH CAROLINA, LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABA AUTISM SERVICES OF SOUTH CAROLINA, LLP
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:
Provider Other Organization Name Type Code:
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:
1215329750
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
419 THE PARKWAY, PMB #141
Provider Second Line Business Mailing Address:
ABA AUTISM SERVICES OF SC, LLP
Provider Business Mailing Address City Name:
GREER
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29650
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-582-8012
Provider Business Mailing Address Fax Number:
803-306-6743

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
419 THE PARKWAY, PMB #141
Provider Second Line Business Practice Location Address:
ABA AUTISM SERVICES OF SC, LLP
Provider Business Practice Location Address City Name:
GREER
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-580-3720
Provider Business Practice Location Address Fax Number:
803-306-6743
Provider Enumeration Date:
02/20/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SHERMAN
Authorized Official First Name:
STACEY
Authorized Official Middle Name:
P
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
803-582-8012

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com