NPIMap

Organization Active NPI

SC Dept of Disabilities & Special Needs Mulberry PK Units 301-307

  • Intellectual Disabilities Intermediate Care Facility
  • Columbia, SC
National Provider Identifier
1174686018
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
SC DEPT OF DISABILITIES & SPECIAL NEEDS MULBERRY PK UNITS 301-307
Practice address
3440 Harden Street Extension
Columbia, SC 29240-4706
Phone
(803) 898-9600
Fax
(803) 898-9653
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert William Barfield
Title
Deputy State Director Administratio
Phone
(803) 898-9743

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

3440 Harden Street Extension
Columbia, SC 29240-4706

Mailing address

3440 Harden Street Extension
Post Office Box 4706
Columbia, SC 29240-4706
Phone (803) 898-9600

Other identifiers 1

IdentifierTypeStateIssuer
342508MedicaidSC

Other names 1

  • Residential Healthcare Facility Other name

National Provider Directory

National Provider Directory
Tax ID family
SC Dept of Health and Environmental Control280 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174686018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 HARDEN STREET EXTENSION",
            "address_2": "POST OFFICE BOX 4706",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292404706",
            "telephone_number": "803-898-9600",
            "fax_number": "803-898-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 HARDEN STREET EXTENSION",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292404706",
            "telephone_number": "803-898-9600",
            "fax_number": "803-898-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SC DEPT OF DISABILITIES & SPECIAL NEEDS MULBERRY PK UNITS 301-307",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARFIELD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "DEPUTY STATE DIRECTOR ADMINISTRATIO",
        "authorized_official_telephone_number": "803-898-9743",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342508",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Residential Healthcare Facility",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.