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Contact Information

CAROLINA DEVELOPMENTAL CLINIC, LLC
107 VISTA OAKS DR STE C
LEXINGTON, SC29072-8230
 Phone: 803-957-5856
 Fax: 803-957-5856
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Developmental Disabilities

261QD1600X
Indicates primary specialty

NPI Profile & details for CAROLINA DEVELOPMENTAL CLINIC, LLC

NPI Number 1225346737
LBN Legal business name CAROLINA DEVELOPMENTAL CLINIC, LLC
Authorized official SHELLY BRIGMAN - (OWNER AND MEDICAL DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 09/17/2010
Last updated 09/17/2010 - About 16 years ago
Identifiers
SC License # 23497
SC Medicaid 234972
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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