Provider Demographics
NPI:1568114957
Name:GENERAL COUNCIL ON FINANCE & ADMINS
Entity Type:Organization
Organization Name:GENERAL COUNCIL ON FINANCE & ADMINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-754-8936
Mailing Address - Street 1:PO BOX 203
Mailing Address - Street 2:
Mailing Address - City:BALLENTINE
Mailing Address - State:SC
Mailing Address - Zip Code:29002-0203
Mailing Address - Country:US
Mailing Address - Phone:843-754-8936
Mailing Address - Fax:
Practice Address - Street 1:401 WESTERN LN STE 6
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-7953
Practice Address - Country:US
Practice Address - Phone:843-754-8936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENERAL COUNCIL ON FINANCE & ADMINS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCRC1488Medicaid