Provider Demographics
NPI:1205393873
Name:GEORGETOWN COUNTY BOARD OF DISABILITIES AND SPECIAL NEEDS
Entity Type:Organization
Organization Name:GEORGETOWN COUNTY BOARD OF DISABILITIES AND SPECIAL NEEDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-904-6304
Mailing Address - Street 1:PO BOX 1471
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29442-1471
Mailing Address - Country:US
Mailing Address - Phone:843-546-8228
Mailing Address - Fax:843-546-1617
Practice Address - Street 1:95 ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-5802
Practice Address - Country:US
Practice Address - Phone:843-546-8228
Practice Address - Fax:843-546-1617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities