Provider Demographics
NPI:1780077933
Name:GRANTSNET OF CHARLESTON
Entity type:Organization
Organization Name:GRANTSNET OF CHARLESTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL/COO
Authorized Official - Prefix:MS
Authorized Official - First Name:DORIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:JEFFCOAT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:843-860-3587
Mailing Address - Street 1:727 E BAY ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-5857
Mailing Address - Country:US
Mailing Address - Phone:843-860-3587
Mailing Address - Fax:
Practice Address - Street 1:727 E BAY ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5857
Practice Address - Country:US
Practice Address - Phone:843-860-3587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1041C0700X251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health