# ASHLEIGH PLACE, INC.

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

## Provider details

- **NPI number:** 1518924836
- **Authorized official:** MRS. BRENDA DAWN HOLLINGSWORTH L.S.W/L.C.S. (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (803) 284-4433

## Contact information

- **Practice address:** 4435 ASHLEIGH RD, BLACKVILLE, SC 29817-4463
- **Practice address phone:** (803) 284-4433
- **Practice address fax:** (803) 284-0130
- **Mailing address:** 4435 ASHLEIGH RD, BLACKVILLE, SC 29817-4463
- **Mailing address phone:** (803) 284-4433
- **Mailing address fax:** (803) 284-0130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | SR-0000547001-CCI | SC | Yes |

## Other

- **Enumeration date:** 04/28/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 921MXH | — | SC |