Organization
STATE OF SOUTH CAROLINA
Active
Other names
SC DAODAS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LILLIAN ROBERSON (MANAGER, DIVISION OF OPERATIONS)
(803) 896-1145
Entity
Organization
Contact information
Practice address
101 EXECUTIVE CENTER DR, SUITE 215, COLUMBIA, SC 29210-8411
(803) 896-5555
Mailing address
101 EXECUTIVE CENTER DR, SUITE 215, COLUMBIA, SC 29210-8411
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/08/2007
Last updated
07/25/2008
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