Provider Demographics
NPI:1730471665
Name:BILLIE HARDEE HOME FOR BOYS
Entity Type:Organization
Organization Name:BILLIE HARDEE HOME FOR BOYS
Other - Org Name:THE COUNSELING PLACE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:GATES
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-393-8600
Mailing Address - Street 1:PO BOX 617
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29540-0617
Mailing Address - Country:US
Mailing Address - Phone:843-393-8600
Mailing Address - Fax:843-393-6471
Practice Address - Street 1:1133 TIMMONSVILLE HWY
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-5077
Practice Address - Country:US
Practice Address - Phone:843-393-8600
Practice Address - Fax:843-393-6471
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BILLIE HARDEE HOME FOR BOYS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC63751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty