Active NPI
Palmetto Family Service Center, LLC
- Community/Behavioral Health Agency
- Columbia, SC
National Provider Identifier
1871986158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- PALMETTO FAMILY SERVICE CENTER, LLC
- Practice address
- 2638 Two Notch Rd Ste 108
Columbia, SC 29204-1454 - Phone
- (803) 779-7257
- Fax
- (803) 779-5285
- NPI assigned
- Mar 11, 2015
- Organization subpart
- Yes
- Parent organization
- PALMETTO AIDS LIFE SUPPORT SERVICES, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Carmen Hampton Julious, LISW-CP&AP
- Title
- Ceo
- Phone
- (803) 779-7257
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | SC | Primary |
Addresses
Primary practice location
2638 Two Notch Rd Ste 108
Columbia, SC 29204-1454
Mailing address
2638 Two Notch Rd Ste 108
Columbia, SC 29204-1454
Phone (803) 779-7257
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EX0210 | Medicaid | SC |
Other names 1
- PALSS, Inc.
National Provider Directory
National Provider Directory- Tax ID family
- Palmetto AIDS Life Support Services
- Part of
- Palmetto AIDS Life Support Services
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Primary Care Clinic/Center
- Columbia, SC
- NPI 1184829392
-
- Community/Behavioral Health Agency
- Columbia, SC
- NPI 1053730572
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Primary Care Clinic/Center
- Columbia, SC
- NPI 1184829392
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426032000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1426032000000",
"number": "1871986158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2638 TWO NOTCH RD STE 108",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292041454",
"telephone_number": "803-779-7257",
"fax_number": "803-779-5285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2638 TWO NOTCH RD STE 108",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292041454",
"telephone_number": "803-779-7257",
"fax_number": "803-779-5285"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PALMETTO FAMILY SERVICE CENTER, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PALMETTO AIDS LIFE SUPPORT SERVICES, INC.",
"enumeration_date": "2015-03-11",
"last_updated": "2015-03-11",
"status": "A",
"authorized_official_last_name": "JULIOUS",
"authorized_official_first_name": "CARMEN",
"authorized_official_middle_name": "HAMPTON",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "803-779-7257",
"authorized_official_credential": "LISW-CP&AP"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "SC",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "EX0210",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "PALSS, Inc.",
"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 Mar 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.