Provider Demographics
NPI:1578296638
Name:S.C. (SOUTH CAROLINA) AGING MATTERS CONSULTANCY ,LLC
Entity Type:Organization
Organization Name:S.C. (SOUTH CAROLINA) AGING MATTERS CONSULTANCY ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-624-3422
Mailing Address - Street 1:109 DANIEL ST
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29532-4727
Mailing Address - Country:US
Mailing Address - Phone:843-624-3422
Mailing Address - Fax:843-968-8052
Practice Address - Street 1:44 PUBLIC SQ STE 100
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-3220
Practice Address - Country:US
Practice Address - Phone:843-624-3422
Practice Address - Fax:843-968-8052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management