Organization
SC DEPT OF DISABILITIES AND SPECIAL NEEDS
Active
Other names
Lemon Park Community Residence
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 STREET EXTENSION, COLUMBIA, SC 29203
(803) 898-9600
(803) 898-9653
Mailing address
POST OFFICE BOX 4706, 3440 HARDEN STREET 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
—
0836NH
—
SC
Enumeration date
12/19/2006
Last updated
08/22/2020
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