Provider Demographics
NPI:1235982554
Name:DEPARTMENT OF MENTAL HEALTH
Entity Type:Organization
Organization Name:DEPARTMENT OF MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QA COOPERATE COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:DALANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-260-2220
Mailing Address - Street 1:200 MCGEE RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625-2104
Mailing Address - Country:US
Mailing Address - Phone:864-260-2220
Mailing Address - Fax:
Practice Address - Street 1:200 MCGEE RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-2104
Practice Address - Country:US
Practice Address - Phone:864-260-2220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty