Provider Demographics
NPI:1750703815
Name:DORCHESTER COUNTY DISABILITIES AND SPECIAL NEEDS BOARD
Entity type:Organization
Organization Name:DORCHESTER 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:CELESTE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-871-1285
Mailing Address - Street 1:2717 W 5TH NORTH ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-9605
Mailing Address - Country:US
Mailing Address - Phone:843-871-1285
Mailing Address - Fax:843-871-2929
Practice Address - Street 1:2717 W 5TH NORTH ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-9605
Practice Address - Country:US
Practice Address - Phone:843-871-1285
Practice Address - Fax:843-871-2929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251B00000X, 251C00000X, 252Y00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No252Y00000XAgenciesEarly Intervention Provider Agency