Organization
AVALONIA GROUP HOMES, INC.
Active
Other names
Hampton P.R.T.F.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARVIN J. SHORT III J.D. (PRESIDENT)
(864) 313-6967
Entity
Organization
Contact information
Practice address
404 HAMPTON AVE, PICKENS, SC 29671-2608
(864) 897-8050
(864) 878-7276
Mailing address
PO BOX 1214, PICKENS, SC 29671-1214
(864) 897-8050
(864) 878-7276
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
RTF-0020
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RTF-0020
SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIORNMENTAL CONTROL
SC
Enumeration date
10/09/2008
Last updated
10/09/2008
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