Provider Demographics
NPI:1407394281
Name:SINGLE PARENT INSTITUTE (SPI)
Entity Type:Organization
Organization Name:SINGLE PARENT INSTITUTE (SPI)
Other - Org Name:SINGLE PARENT INSTITUTE (SPI)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:QUANECK
Authorized Official - Last Name:WALKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-223-9408
Mailing Address - Street 1:546 S PIKE W
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-2616
Mailing Address - Country:US
Mailing Address - Phone:803-223-9408
Mailing Address - Fax:
Practice Address - Street 1:546 S PIKE W
Practice Address - Street 2:SUITE 4
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-2616
Practice Address - Country:US
Practice Address - Phone:803-223-9408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No251S00000XAgenciesCommunity/Behavioral Health