Provider Demographics
NPI:1821337098
Name:BEHAVIORAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOULKES-JAMISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-407-5920
Mailing Address - Street 1:7320 COLLEGE ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-2944
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7320 COLLEGE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-2944
Practice Address - Country:US
Practice Address - Phone:803-407-5920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPY803261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPS0333Medicaid