NPIMap

Organization Active NPI

Three Rivers Residential Treatment Midlands Campus, Inc.

  • Psychiatric Residential Treatment Facility
  • West Columbia, SC
National Provider Identifier
1144253824
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
RTC-018 Issued in SC
Legal business name
THREE RIVERS RESIDENTIAL TREATMENT MIDLANDS CAMPUS, INC.
Practice address
200 Ermine Rd
West Columbia, SC 29170-2024
Phone
(803) 791-9918
Fax
(803) 926-5925
NPI assigned
Jul 8, 2006
Organization subpart
Yes
Parent organization
UNIVERSAL HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Authorized official

Name
Joelle L Vincent
Title
Bod
Phone
(843) 851-5208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X RTC-018 SC Primary

Addresses

Primary practice location

200 Ermine Rd
West Columbia, SC 29170-2024

Mailing address

200 Ermine Rd
West Columbia, SC 29170-2024
Phone (803) 791-9918

Other identifiers 1

IdentifierTypeStateIssuer
RTF004MedicaidSC

Other names 1

  • ABS New Hope Midlands, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Abs New Hope Midlands Inc4 organizations share this tax ID, including this one
Part of
Universal Health Servic

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1144253824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ERMINE RD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291702024",
            "telephone_number": "803-791-9918",
            "fax_number": "803-926-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ERMINE RD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291702024",
            "telephone_number": "803-791-9918",
            "fax_number": "803-926-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS RESIDENTIAL TREATMENT MIDLANDS CAMPUS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSAL HEALTH SERVICES, INC.",
        "enumeration_date": "2006-07-08",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "JOELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BOD",
        "authorized_official_telephone_number": "843-851-5208"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "SC",
            "license": "RTC-018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RTF004",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABS New Hope Midlands, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.