Provider Demographics
NPI:1942235502
Name:AIKEN COUNTY
Entity Type:Organization
Organization Name:AIKEN COUNTY
Other - Org Name:MATTIE C. HALL HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNTY COUNCIL CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-642-1690
Mailing Address - Street 1:830 LAURENS ST
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-3416
Mailing Address - Country:US
Mailing Address - Phone:803-649-6264
Mailing Address - Fax:
Practice Address - Street 1:830 LAURENS ST
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-3416
Practice Address - Country:US
Practice Address - Phone:803-649-6264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCNCF-408314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC313415Medicaid
SC313415Medicaid