Provider Demographics
NPI:1306187984
Name:AIKEN BARNWELL MENTAL HEALTH
Entity Type:Organization
Organization Name:AIKEN BARNWELL MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN SERVICE COORDINATOR I
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:GRIGSBY
Authorized Official - Suffix:
Authorized Official - Credentials:MMFT
Authorized Official - Phone:803-641-3940
Mailing Address - Street 1:1480 W O EZELL BLVD APT I68
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-1543
Mailing Address - Country:US
Mailing Address - Phone:803-641-3940
Mailing Address - Fax:
Practice Address - Street 1:1135 GREGG HWY
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6341
Practice Address - Country:US
Practice Address - Phone:803-641-7700
Practice Address - Fax:803-641-7709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health