Organization
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC
Active
Organization
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC
Active
Other names
Eau Claire Behavioral Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DELGADO CANTAVE MD (CEO)
(803) 733-5969
Entity
Organization
Contact information
Practice address
4605 MONTICELLO RD, BUILDING B, STE.1, COLUMBIA, SC 29203-4156
(803) 714-0266
(803) 753-6333
Mailing address
PO BOX 3788, COLUMBIA, SC 29230-3788
(803) 753-5591
(803) 753-5591
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CBP018
—
SC
05
—
FQC031
—
SC
05
—
FQC187
—
SC
Enumeration date
07/20/2010
Last updated
02/10/2022
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