Provider Demographics
NPI:1861496234
Name:CHARLESTON COUNTY GOVERNMENT
Entity Type:Organization
Organization Name:CHARLESTON COUNTY GOVERNMENT
Other - Org Name:CHARLESTON CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNTY ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TUTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-958-4013
Mailing Address - Street 1:PO BOX 70289
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29415-0289
Mailing Address - Country:US
Mailing Address - Phone:843-958-3300
Mailing Address - Fax:843-958-3498
Practice Address - Street 1:3685 RIVERS AVENUE
Practice Address - Street 2:SUITE 301
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-7746
Practice Address - Country:US
Practice Address - Phone:843-958-3300
Practice Address - Fax:843-958-3498
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHARLESTON COUNTY GOVERNMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-13
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCITP 18324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCADO3CHMedicaid
SCGP0939Medicaid