# LAURELCREST

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427412980
- **Authorized official:** MRS. PAM BIDENAGEL RN (DIRECTOR OF REHAB)
- **Authorized official phone:** (864) 544-2323

## Contact information

- **Practice address:** 100 JOSEPH WALKER DR, WEST COLUMBIA, SC 29169-6971
- **Practice address phone:** (803) 796-0370
- **Mailing address:** 34 WOODCROSS DR APT 1203, COLUMBIA, SC 29212-2365
- **Mailing address phone:** (803) 719-2206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 2310 | SC | Yes |

## Other

- **Enumeration date:** 04/11/2016
- **Last updated:** 04/11/2016