Provider Demographics
NPI:1982086617
Name:SENIOR CITIZENS ASSOCIATION IN FLORENCE COUNTY
Entity Type:Organization
Organization Name:SENIOR CITIZENS ASSOCIATION IN FLORENCE COUNTY
Other - Org Name:FLORENCE COUNTY COUNCIL ON AGING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-669-6761
Mailing Address - Street 1:600 SENIOR WAY
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6080
Mailing Address - Country:US
Mailing Address - Phone:843-669-6761
Mailing Address - Fax:843-665-2266
Practice Address - Street 1:600 SENIOR WAY
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6080
Practice Address - Country:US
Practice Address - Phone:843-669-6761
Practice Address - Fax:843-665-2266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2172101YA0400X, 101YM0800X, 101YP2500X, 106H00000X, 251B00000X, 251S00000X, 332U00000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332U00000XSuppliersHome Delivered Meals
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)