NPIMap

Organization Active NPI

Clemson University

  • Community/Behavioral Health Agency
  • Pickens, SC
National Provider Identifier
1689901795
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CLEMSON UNIVERSITY
Practice address
698 Concord Church Rd
Pickens, SC 29671-9167
Phone
(864) 878-1103
Fax
(864) 878-5985
NPI assigned
Nov 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Authorized official

Name
Mr. Jorge M Calzadilla
Title
Executive Director
Phone
(864) 878-1103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

698 Concord Church Rd
Pickens, SC 29671-9167

Mailing address

698 Concord Church Rd
Pickens, SC 29671-9167
Phone (864) 878-1103

Other names 1

  • Youth Learning Institute Other name

National Provider Directory

National Provider Directory
Tax ID family
Clemson University-Redfern Health Center8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

698 Concord Church Rd
Pickens, SC 29671
Phone (864) 878-1103

NPI Registry JSON

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257811200000",
    "number": "1689901795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "698 CONCORD CHURCH RD",
            "city": "PICKENS",
            "state": "SC",
            "postal_code": "296719167",
            "telephone_number": "864-878-1103",
            "fax_number": "864-878-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "698 CONCORD CHURCH RD",
            "city": "PICKENS",
            "state": "SC",
            "postal_code": "296719167",
            "telephone_number": "864-878-1103",
            "fax_number": "864-878-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMSON UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-10",
        "last_updated": "2009-11-10",
        "status": "A",
        "authorized_official_last_name": "CALZADILLA",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "864-878-1103",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Youth Learning Institute",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pickens, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.