Provider Demographics
NPI:1184826380
Name:YORK COUNTY BOARD OF DISABILITIES & SPECIAL NEEDS
Entity Type:Organization
Organization Name:YORK COUNTY BOARD OF DISABILITIES & SPECIAL NEEDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-628-5999
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29731-6030
Mailing Address - Country:US
Mailing Address - Phone:803-628-5999
Mailing Address - Fax:803-628-7984
Practice Address - Street 1:7900 PARK PLACE RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:SC
Practice Address - Zip Code:29745-7476
Practice Address - Country:US
Practice Address - Phone:803-628-5999
Practice Address - Fax:803-628-7984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC73284320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities