Provider Demographics
NPI:1134853062
Name:H2HOME THERAPY, INC
Entity type:Organization
Organization Name:H2HOME THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:CLAYBERG
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, LISW-CP
Authorized Official - Phone:803-429-5302
Mailing Address - Street 1:721 REVERDY CT
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-7970
Mailing Address - Country:US
Mailing Address - Phone:803-429-5302
Mailing Address - Fax:833-279-0655
Practice Address - Street 1:721 REVERDY CT
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-7970
Practice Address - Country:US
Practice Address - Phone:803-429-5302
Practice Address - Fax:833-279-0655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSW1197Medicaid