Provider Demographics
NPI:1134288715
Name:SPARTANBURG SCHOOL DISTRICT ONE
Entity Type:Organization
Organization Name:SPARTANBURG SCHOOL DISTRICT ONE
Other - Org Name:OFFICE OF SPECIAL SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SPECIAL SERVICES DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:864-472-4117
Mailing Address - Street 1:121 WHEELER STREET
Mailing Address - Street 2:P. O. BOX 218
Mailing Address - City:CAMPOBELLO
Mailing Address - State:SC
Mailing Address - Zip Code:29322-0218
Mailing Address - Country:US
Mailing Address - Phone:864-472-4117
Mailing Address - Fax:864-472-4118
Practice Address - Street 1:121 WHEELER STREET
Practice Address - Street 2:
Practice Address - City:CAMPOBELLO
Practice Address - State:SC
Practice Address - Zip Code:29322-0218
Practice Address - Country:US
Practice Address - Phone:864-472-4117
Practice Address - Fax:864-472-4118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSD4201Medicaid