# PRISMA HEALTH-UPSTATE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prisma Health Marshall I Pickens Childrens
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295280063
- **Authorized official:** POLLY H. MILLER (VP PAYOR STRATEGIES & ALIGNMENT)
- **Authorized official phone:** (864) 522-2286

## Contact information

- **Practice address:** 701 GROVE RD, GREENVILLE, SC 29605-4210
- **Practice address phone:** (864) 455-7000
- **Mailing address:** 300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
- **Mailing address phone:** (864) 455-7000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | RTF-0031 | SC | Yes |

## Other

- **Enumeration date:** 08/22/2016
- **Last updated:** 02/04/2021