Organization
COMMUNITY LIFE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES NOLON (PRESIDENT)
(803) 260-2962
Entity
Organization
Contact information
Practice address
121-C JOHN MARK DIAL DR., COLUMBIA, SC 29209-2882
(803) 260-2962
Mailing address
121 JOHN MARK DIAL DR STE C, COLUMBIA, SC 29209-9422
(803) 260-2962
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/24/2009
Last updated
05/31/2011
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