Organization
SC DEPT OF DISABILITIES & SPECIAL NEEDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT WILLIAM BARFIELD (DEPUTY STATE DIRECTOR ADMINISTRATIO)
(803) 898-9743
Entity
Organization
Contact information
Practice address
3440 HARDEN ST EXTENSION, COLUMBIA, SC 29203
(803) 898-9600
(803) 898-9653
Mailing address
PO BOX 4706, 3440 HARDEN ST EXTENSION, COLUMBIA, SC 29240-4706
(803) 898-9600
(803) 898-9653
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101MR
—
SC
05
—
0202MR
—
SC
05
—
0303MR
—
SC
05
—
0404MR
—
SC
05
—
0505MR
—
SC
05
—
0606MR
—
SC
05
—
0707MR
—
SC
05
—
0808MR
—
SC
05
—
0909MR
—
SC
05
—
1010MR
—
SC
05
—
1111MR
—
SC
05
—
1212MR
—
SC
05
—
1313MR
—
SC
05
—
1414MR
—
SC
05
—
1515MR
—
SC
05
—
1616MR
—
SC
05
—
1717MR
—
SC
05
—
1818MR
—
SC
05
—
1919MR
—
SC
05
—
2020MR
—
SC
Enumeration date
11/09/2005
Last updated
08/22/2020
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