Provider Demographics
NPI:1598281255
Name:DEVELOPMENTAL CENTER FOR EXCEPTIONAL CHILDREN
Entity Type:Organization
Organization Name:DEVELOPMENTAL CENTER FOR EXCEPTIONAL CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:S
Authorized Official - Last Name:BAYSDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-260-4546
Mailing Address - Street 1:1100 W FRANKLIN STREET
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29624
Mailing Address - Country:US
Mailing Address - Phone:864-260-4546
Mailing Address - Fax:864-231-1766
Practice Address - Street 1:1100 WEST FRANKLIN STREET
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29624
Practice Address - Country:US
Practice Address - Phone:864-260-4546
Practice Address - Fax:864-231-1766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCP47455164W00000X
SC2251P0200X, 225XP0200X, 2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty