NPIMap

Organization Active NPI

South Carolina Dept of Mental Health Accounting Office

Doing business as Earle E Morris Jr Alcohol & Drug Addiction Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Columbia, SC
National Provider Identifier
1295787869
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
HTL-516 Issued in SC
Legal business name
SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
Doing business as
Earle E Morris Jr Alcohol & Drug Addiction Treatment Center
Practice address
610 Faison Dr
Columbia, SC 29203-3218
Phone
(803) 898-8405
Fax
(803) 898-8526
NPI assigned
May 16, 2006
Last updated
Sep 20, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH CAROLINA DEPT OF MENTAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Authorized official

Name
Versie J Bellamy
Title
Deputy Director
Phone
(803) 935-5761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X HTL-516 SC Primary

Addresses

Primary practice location

610 Faison Dr
Columbia, SC 29203-3218

Mailing address

PO Box 485
Columbia, SC 29202-0485
Phone (803) 898-8405

Other identifiers 1

IdentifierTypeStateIssuer
GP1799MedicaidSC

Other names 1

  • Earle E Morris Jr Alcohol & Drug Addiction Treatment Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000630 SC Part B Supplier - Clinic/Group Practice 9032021175 Receives reassigned benefits from 136 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbia, SC; Charleston, SC; Anderson, SC; Aiken, SC

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pee Dee Mental Health C61 organizations share this tax ID, including this one
Part of
Pee Dee Mental Health C

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

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1295787869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 485",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292020485",
            "telephone_number": "803-898-8405",
            "fax_number": "803-898-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 FAISON DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292033218",
            "telephone_number": "803-898-8405",
            "fax_number": "803-898-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CAROLINA DEPT OF MENTAL HEALTH",
        "enumeration_date": "2006-05-16",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "BELLAMY",
        "authorized_official_first_name": "VERSIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "803-935-5761"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "SC",
            "license": "HTL-516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1799",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Earle E Morris Jr Alcohol & Drug Addiction Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Earle E Morris Jr Alcohol & Drug Addiction Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.