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Organization

A TEAM HEALTHCARE SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. URSHULA CANNON (OWNER)
(803) 361-5249
Entity
Organization

Contact information

Practice address
3935 SUNSET BLVD, STE. G., WEST COLUMBIA, SC 29169-2403
(803) 796-9612
(803) 796-9615
Mailing address
PO BOX 50232, COLUMBIA, SC 29250-0232
(803) 361-5249

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
85573
SC
251C00000X
Developmentally Disabled Services Day Training Agency
85573
SC
251S00000X
Community/Behavioral Health Agency
85573
SC
253J00000X
Foster Care Agency
85573
SC

Other

Enumeration date
01/03/2013
Last updated
01/03/2013
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