Provider Demographics
NPI:1952689697
Name:FEDERATION OF FAMILIES OF SOUTH CAROLINA
Entity Type:Organization
Organization Name:FEDERATION OF FAMILIES OF SOUTH CAROLINA
Other - Org Name:FEDERATION OF FAMILIES OF SC
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:REVELS
Authorized Official - Last Name:FLASHNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-772-5210
Mailing Address - Street 1:810 DUTCH SQUARE BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-7318
Mailing Address - Country:US
Mailing Address - Phone:803-772-5210
Mailing Address - Fax:803-772-5212
Practice Address - Street 1:810 DUTCH SQUARE BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-7318
Practice Address - Country:US
Practice Address - Phone:803-772-5210
Practice Address - Fax:803-772-5212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health