Organization
CLARENDON BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN KIRVEN (INTERUM CEO)
(803) 435-2121
Entity
Organization
Contact information
Practice address
14 N. CHURCH STREET, MANNING, SC 29102
(803) 435-2121
(803) 435-8856
Mailing address
14 N. CHURCH STREET, MANNING, SC 29102
(803) 435-2121
(803) 435-8856
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730176934
—
SC
Enumeration date
10/14/2016
Last updated
10/14/2016
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