Organization
WILLIAM J. MCCORD ADOLESCENT TREATMENT FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE DENNIS (DIRECTOR)
(803) 534-2328
Entity
Organization
Contact information
Practice address
910 COOK RD, ORANGEBURG, SC 29118-2124
(803) 534-2328
Mailing address
416 MEADOWLAKE DR, COLUMBIA, SC 29203-2418
(803) 606-9783
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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