Provider Demographics
NPI:1033251228
Name:OCONEE COUNTY DISABILITIES & SPECIAL NEEDS BOARD
Entity Type:Organization
Organization Name:OCONEE COUNTY DISABILITIES & SPECIAL NEEDS BOARD
Other - Org Name:TRIBBLE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSIST EXECUTIVE DIR
Authorized Official - Prefix:MR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:REX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-885-6055
Mailing Address - Street 1:116 S COVE RD
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29672-6711
Mailing Address - Country:US
Mailing Address - Phone:864-885-6053
Mailing Address - Fax:864-885-6058
Practice Address - Street 1:116 S COVE RD
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29672-6711
Practice Address - Country:US
Practice Address - Phone:864-885-6053
Practice Address - Fax:864-885-6058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty