Provider Demographics
NPI:1740845940
Name:FLORENCE COUNTY DISABILITIES AND SPECIAL NEEDS BOARD
Entity type:Organization
Organization Name:FLORENCE COUNTY DISABILITIES AND SPECIAL NEEDS BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:S
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-667-5007
Mailing Address - Street 1:1211 E NATIONAL CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-3240
Mailing Address - Country:US
Mailing Address - Phone:843-667-5007
Mailing Address - Fax:843-678-8597
Practice Address - Street 1:1211 E NATIONAL CEMETERY RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-3240
Practice Address - Country:US
Practice Address - Phone:843-667-5007
Practice Address - Fax:843-678-8597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency