Provider Demographics
NPI:1689910572
Name:SOUTH CAROLINA DEPARTMENT OF SOCIAL SERVICES
Entity Type:Organization
Organization Name:SOUTH CAROLINA DEPARTMENT OF SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-898-7567
Mailing Address - Street 1:1535 CONFEDERATE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-1915
Mailing Address - Country:US
Mailing Address - Phone:803-898-7567
Mailing Address - Fax:803-898-7641
Practice Address - Street 1:2638 TWO NOTCH RD
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-1454
Practice Address - Country:US
Practice Address - Phone:803-898-8940
Practice Address - Fax:803-898-8971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-20
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management