Organization
PROFESSIONAL PRODUCTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES L AIKEN (MANAGER)
(866) 591-1820
Entity
Organization
Contact information
Practice address
1800 MAIN ST STE 100, COLUMBIA, SC 29201-2433
(866) 591-1820
(866) 591-1820
Mailing address
PO BOX 3548, COLUMBIA, SC 29230-3548
(803) 252-6610
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
SC
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EX3033
—
SC
Enumeration date
07/13/2006
Last updated
12/28/2009
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