Provider Demographics
NPI:1558823880
Name:SUMTER COUNTY DISABILITIES AND SPECIAL NEEDS BOARDS
Entity Type:Organization
Organization Name:SUMTER COUNTY DISABILITIES AND SPECIAL NEEDS BOARDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-778-1669
Mailing Address - Street 1:PO BOX 2847
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29151-2847
Mailing Address - Country:US
Mailing Address - Phone:803-778-1669
Mailing Address - Fax:803-775-9194
Practice Address - Street 1:750 ELECTRIC DR
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29153-1934
Practice Address - Country:US
Practice Address - Phone:803-778-1669
Practice Address - Fax:803-775-9194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency