Eau Claire Developmental Clinic
LBN: Eau Claire Cooperative Health Center, Inc.
Eau Claire Developmental Clinic is an health care organization with primary practice located at 4601 Monticello Road , Columbia SC 29203. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty.
Eau Claire Cooperative Health Center, Inc. can be contacted via phone (803) 356-7102, or through Cantave, Delgado via phone (803) 733-5969.
Contact Information
Primary practice address
4601 Monticello Road
Columbia SC 29203
Phone: (803) 356-7102
Fax: (803) 356-7106
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics | 2080P0006X | ||
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X |
Profile Details
| NPI number | 1023407996 |
|---|---|
| LBN Legal business name | Eau Claire Cooperative Health Center, Inc. |
| DBA Doing business as | Eau Claire Developmental Clinic |
| Authorized official | Cantave, Delgado |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 15th, 2015 |
| Last updated | Feb 3rd, 2022 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023407996 | NPPES |
| South Carolina | MEDICAID | CBP018 | |
| South Carolina | MEDICAID | FQC031 | |
| South Carolina | MEDICAID | FQC181 |
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