Organization
THE CENTER OF CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEBURN SANDERS (PROGRAM DIRECTOR)
(803) 755-7787
Entity
Organization
Contact information
Practice address
1228 MAIN ST, WEST COLUMBIA, SC 29170-4026
(803) 755-7787
(803) 755-2666
Mailing address
PO BOX 12043, COLUMBIA, SC 29211-2043
(803) 755-7787
(803) 755-2666
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
930MXH
—
SC
Enumeration date
02/12/2007
Last updated
08/22/2020
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