Provider Demographics
NPI:1386028512
Name:MENTAL HEALTH AMERICA SOUTH CAROLINA
Entity Type:Organization
Organization Name:MENTAL HEALTH AMERICA SOUTH CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:JAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-779-5363
Mailing Address - Street 1:1823 GADSDEN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2344
Mailing Address - Country:US
Mailing Address - Phone:803-779-5363
Mailing Address - Fax:803-929-6147
Practice Address - Street 1:1823 GADSDEN ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2344
Practice Address - Country:US
Practice Address - Phone:803-779-5363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health