Active NPI
Purpose-SC
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Greenville, SC
National Provider Identifier
1124260427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Legal business name
- PURPOSE-SC
- Practice address
- 5321 Old Buncombe Rd
Greenville, SC 29609-0910 - Phone
- (864) 313-4530
- NPI assigned
- Apr 1, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Latonya Williams
- Title
- Executive Director Adult Services
- Phone
- (864) 313-4530
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility (Behavioral Disturbances) | 3104A0630X | |||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Primary |
Addresses
Primary practice location
5321 Old Buncombe Rd
Greenville, SC 29609-0910
Mailing address
5321 Old Buncombe Rd
Greenville, SC 29609-0910
Phone (864) 313-5274
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 936MXH | Medicaid | SC | |
| 883MXH | Medicaid | SC |
National Provider Directory
National Provider DirectoryLocations
1399 Harmony Camp Rd
Greeleyville, SC 29056
Phone (803) 473-4656
5321 Old Buncombe Rd
Greenville, SC 29609
Phone (864) 313-4530
1991 Glenns Bay Rd
Myrtle Beach, SC 29575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238544000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1724284800000",
"number": "1124260427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5321 OLD BUNCOMBE RD",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296090910",
"telephone_number": "864-313-5274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5321 OLD BUNCOMBE RD",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296090910",
"telephone_number": "864-313-4530"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PURPOSE-SC",
"organizational_subpart": "NO",
"enumeration_date": "2009-04-01",
"last_updated": "2024-08-22",
"certification_date": "2024-08-22",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "LATONYA",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR ADULT SERVICES",
"authorized_official_telephone_number": "864-313-4530"
},
"taxonomies": [
{
"code": "3104A0630X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
"state": null,
"license": null,
"primary": false
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "936MXH",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "883MXH",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.