Organization
SOUTH CAROLINA CENTER FOR GRASSROOTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS J. SIMUEL (PRESIDENT/CEO)
(803) 454-1130
Entity
Organization
Contact information
Practice address
1105 BELLEVIEW ST, COLUMBIA, SC 29201-1839
(803) 454-1130
Mailing address
1105 BELLEVIEW ST, COLUMBIA, SC 29201-1839
(803) 454-1130
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/10/2007
Last updated
12/10/2007
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