Clarendon Behavioral Health

Organization Active NPI Health Maintenance Organization · Manning, SC

NPI 1629529698 · NPPES record last updated Oct 14, 2016

Key facts

NPI
1629529698
Entity type
Organization (NPI type 2)
Primary specialty
Health Maintenance Organization 302R00000X
Legal business name
CLARENDON BEHAVIORAL HEALTH
Practice address
14 N. Church Street
Manning, SC 29102
Phone
(803) 435-2121
Fax
(803) 435-8856
NPI assigned
Oct 14, 2016
Organization subpart
No

Authorized official

Name
Ann Kirven
Title
Interum Ceo
Phone
(803) 435-2121

Corporate family (same tax ID) 1

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

National Provider Directory

Tax ID family
Clarendon Behavioral Health (2 organizations share this tax ID)

Locations

14 N Church St
Manning, SC 29102
Phone (803) 435-2121

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X SC Yes

Addresses

Primary practice location

14 N. Church Street
Manning, SC 29102

Mailing address

14 N. Church Street
Manning, SC 29102
Phone (803) 435-2121

Other identifiers

IdentifierTypeStateIssuer
1730176934MedicaidSC

Other providers in Manning, SC

All providers in Manning, SC · Health Maintenance Organization in South Carolina

Sources for this page

Verify at the official NPI Registry.