CIRCLEPARK BEHAVIORAL HEALTH SERICES (NPI# 1740250703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740250703 |
| Entity Type | Organization |
| Organization Name | CIRCLEPARK BEHAVIORAL HEALTH SERICES |
| Practice Address |
601 Gregg Avenue Circle Park Behavioral Health Services Florence SC 29502-6196 |
| Practice Telephone | 8436659349 |
| Practice Fax Number | 8436671615 |
| Mailing Telephone | 8436659349 |
| Mailing Fax Number | 8436671615 |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. CHARLES R YOUNG (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8436659349 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Street Address |
601 GREGG AVENUE CIRCLE PARK BEHAVIORAL HEALTH SERVICES |
| City | FLORENCE |
| State | SC |
| Zip Code | 29502-6196 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447583984 | Florence County Commission On Alcohol and Dru | Community/Behavioral Health | 601 Gregg Avenue, Florence, SC 29501 | 2009-09-16 |
| 1548392913 | Joseph E Mack | Counselor | 601 Gregg Avenue, Circle Park Behavioral Health Services, Florence, SC 29502-6196 | 2007-03-12 |
| 1386773141 | Natasha Page Cox | Counselor | 601 Gregg Avenue, Florence, SC 29502-6196 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649645037 | Reghan Boehmke | Specialist/Technologist | 4622 E Palmetto St, Florence, SC 29502 | 2015-12-10 |
| 1497120828 | Francis Marion University | Clinic/Center | 4622 E. Palmetto St, Florence, SC 29502 | 2015-12-10 |
| 1740498260 | Lakia Easton | Occupational Therapist | 1834 Sally Hill Farm Blvd., Florence, SC 29502 | 2007-05-18 |
| 1356561518 | Upender Singh | Physical Therapist | 1834 Sally Hill Farm Blvd, Florence, SC 29502 | 2007-04-27 |
| 1164403184 | Florence Visiting Nurses Service Inc | Home Health | 1605-c W Palmetto St, Florence, SC 29502 | 2005-11-08 |
| 1821113622 | Ricky Ray Martin | Counselor | 601 Gregg Ave, Florence, SC 29502 | 2007-03-20 |
| 1326008350 | Kelli Jo Hansen | Nurse Anesthetist, Certified Registered | 555 Cheves Street, Florence, SC 29502 | 2006-03-24 |
| 1508286550 | David Ismael Estephan | Internal Medicine | Po Box 100551, Florence, SC 29502-0551 | 2014-04-17 |
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235797812 | Wise Care Services, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 1435 Deberry Blvd, Florence, SC 29501-5601 | 2019-05-30 |
| 1003059585 | Community Alliance for Youth and Familly Services | Residential Treatment Facility, Emotionally Disturbed Children | 23568 N Oasis Blvd, Florence, AZ 85232-8068 | 2009-04-13 |
| 1841303898 | North Alabama Christian Childrens Home | Residential Treatment Facility, Emotionally Disturbed Children | 6372 County Road #63, Florence, AL 35630 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366937021 | Doors To Freedom | Residential Treatment Facility, Emotionally Disturbed Children | 1317m N Main St # 263, Summerville, SC 29483-7307 | 2018-06-26 |
| 1205297967 | Potter's House Palmetto, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 104 E Berry St, Lincolnville, SC 29485-7204 | 2016-03-09 |
| 1710342522 | New Directions | Residential Treatment Facility, Emotionally Disturbed Children | 3685 Travertine Dr, Lancaster, SC 29720-6934 | 2015-12-21 |
| 1609219906 | Billie Hardee Home for Boys | Residential Treatment Facility, Emotionally Disturbed Children | 1120 Timmonsville Hwy, Darlington, SC 29532-9998 | 2013-04-17 |
| 1205175452 | S.c Department of Juvenile Justice | Residential Treatment Facility, Emotionally Disturbed Children | 2112 Chandler Ave, Columbia, SC 29210-6204 | 2013-02-07 |
| 1477820504 | Cherokee Creek Boys School | Residential Treatment Facility, Emotionally Disturbed Children | 198 Cooper Rd, Westminster, SC 29693-3309 | 2011-11-17 |
| 1124260427 | Broadstep Academy-sc, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1370 N Williamsburg County Hwy, Kingstree, SC 29556-7027 | 2009-04-01 |
| 1235325242 | New Beginnings of Charleston Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 716 W Front St, Lincolnville, SC 29485-7112 | 2007-09-24 |
| 1639399553 | Orangeburg Attention Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 155 Wall St Rm 16, Orangeburg, SC 29115-5404 | 2007-04-26 |
| 1992846869 | The Center of Change | Residential Treatment Facility, Emotionally Disturbed Children | 1228 Main St, West Columbia, SC 29170-4026 | 2007-02-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.