NPIMap

Organization Active NPI

Lutheran Family Services in the Carolinas

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Columbia, SC
National Provider Identifier
1215073440
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
SR-0008193001 GH Issued in SC
Legal business name
LUTHERAN FAMILY SERVICES IN THE CAROLINAS
Practice address
4240 Timberlane Dr
Columbia, SC 29205-4941
Phone
(803) 790-0810
NPI assigned
Jan 29, 2007
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. Dwight Murray
Title
Ar and Contracts Manger
Phone
(919) 861-2850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X SR-0008193001 GH SC Primary

Addresses

Primary practice location

4240 Timberlane Dr
Columbia, SC 29205-4941

Mailing address

PO Box 12287
Raleigh, NC 27605-2287
Phone (919) 832-2620

Other identifiers 1

IdentifierTypeStateIssuer
928MXHMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Counseling Cen29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215073440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12287",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276052287",
            "telephone_number": "919-832-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 TIMBERLANE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292054941",
            "telephone_number": "803-790-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN FAMILY SERVICES IN THE CAROLINAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "AR AND CONTRACTS MANGER",
        "authorized_official_telephone_number": "919-861-2850",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "SC",
            "license": "SR-0008193001 GH",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "928MXH",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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.