Spartanburg Christian Discipleship Center'S Reach Program

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

102779 Issued in SC

Legal business name

SPARTANBURG CHRISTIAN DISCIPLESHIP CENTER'S REACH PROGRAM

Practice address

150 Kensington Dr
Spartanburg, SC 29306-3983

Phone

(864) 595-0515

Fax

(864) 595-0516

NPI assigned

Apr 8, 2008

Organization subpart

Yes

Parent organization

PROMISED LAND CDCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tommy E. Quick

Title

Executive Director

Phone

(864) 595-0515

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1124291414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 170393",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293010026",
            "telephone_number": "864-595-0515",
            "fax_number": "864-595-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 KENSINGTON DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293063983",
            "telephone_number": "864-595-0515",
            "fax_number": "864-595-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTANBURG CHRISTIAN DISCIPLESHIP CENTER'S REACH PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROMISED LAND CDC",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "QUICK",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "864-595-0515"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "SC",
            "license": "102779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Early Intervention Provider Agency in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Early Intervention Provider Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.