Provider Demographics
NPI:1265413074
Name:SC DEPT OF DISABILITIES & SPECIAL NEEDS
Entity type:Organization
Organization Name:SC DEPT OF DISABILITIES & SPECIAL NEEDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY STATE DIRECTOR ADMINISTRATIO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BARFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-898-9743
Mailing Address - Street 1:PO BOX 4706
Mailing Address - Street 2:3440 HARDEN ST EXTENSION
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29240-4706
Mailing Address - Country:US
Mailing Address - Phone:803-898-9600
Mailing Address - Fax:803-898-9653
Practice Address - Street 1:3440 HARDEN ST EXTENSION
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-898-9600
Practice Address - Fax:803-898-9653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0101MRMedicaid
SC0606MRMedicaid
SC0909MRMedicaid
SC1313MRMedicaid
SC1818MRMedicaid
SC0505MRMedicaid
SC0404MRMedicaid
SC0707MRMedicaid
SC0808MRMedicaid
SC1515MRMedicaid
SC1717MRMedicaid
SC1919MRMedicaid
SC0303MRMedicaid
SC0202MRMedicaid
SC1010MRMedicaid
SC1212MRMedicaid
SC1616MRMedicaid
SC1111MRMedicaid
SC1414MRMedicaid
SC2020MRMedicaid