Provider Demographics
NPI:1033499827
Name:JOYCE C GREGORY
Entity Type:Organization
Organization Name:JOYCE C GREGORY
Other - Org Name:GREGORY'S COMMUNITY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-299-0716
Mailing Address - Street 1:PO BOX 637
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-0637
Mailing Address - Country:US
Mailing Address - Phone:864-299-0716
Mailing Address - Fax:864-299-5347
Practice Address - Street 1:2415 FORK SHOALS RD
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673
Practice Address - Country:US
Practice Address - Phone:864-299-0716
Practice Address - Fax:864-299-5347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCCRC-0556320800000X
SCCRC-0555320800000X
SCCRC-0557320800000X
SCCRC-0558320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness