Provider Demographics
NPI:1629361217
Name:WRIGHT DIRECTIONS FAMILY SERVICS
Entity Type:Organization
Organization Name:WRIGHT DIRECTIONS FAMILY SERVICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-645-7700
Mailing Address - Street 1:PO BOX 1343
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29936-2623
Mailing Address - Country:US
Mailing Address - Phone:843-645-7700
Mailing Address - Fax:
Practice Address - Street 1:60 S RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936-2623
Practice Address - Country:US
Practice Address - Phone:843-645-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-16
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCOTP-0111251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC147BHSMedicaid
SCGP6066Medicaid