PAVILLON GREENVILLE OUTPATIENT SERVICES


Address: 101 Pelham Commons Blvd, Greenville, SC 29615-4974
Phone: 8642416688

PAVILLON GREENVILLE OUTPATIENT SERVICES (NPI# 1780934976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1780934976
Entity Type Organization
Organization Name PAVILLON GREENVILLE OUTPATIENT SERVICES
Practice Address 101 Pelham Commons Blvd
Greenville
SC 29615-4974
Practice Telephone 8642416688
Practice Fax Number 8642416682
Mailing Telephone 8642416688
Mailing Fax Number 8642416682
Enumeration Date 2012-09-14
Last Update Date 2015-03-11
Authorized Official Name MS. NATALIE FRYAR (PROGRAM MANAGER)
Authorized Official Telephone 8642416688
Authorized Official Credential LPC, CACII
Is Organization Subpart Y
Parent Organization Name PAVILLON INTERNATIONAL

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
OTP 0102 SC Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
SC NPI 1023345139 01

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1023345139 Pavillon Greenville Outpatient Services Clinic/Center 125 Pelham Commons Blvd, Greenville, SC 29615-4974 2009-11-10

Office Location

Street Address 101 PELHAM COMMONS BLVD
City GREENVILLE
State SC
Zip Code 29615-4974

Providers in the same location

NPI Name Taxonomy Address Enumeration
1811314735 Joseph G. Feleppa, LLC Social Worker 101 Pelham Commons Blvd, Greenville, SC 29615-4974 2014-03-28

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1629608369 Jennifer Jacobsen Behavior Technician 17 Caldedon Court, Suite B, Greenville, SC 29615 2020-01-22
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1255816070 Trevis L Cureton Pharmacist 2401 East North St, Greenville, SC 29615 2018-09-27
1497232565 Jacob J Fountain Nurse Practitioner 225 Enterprise Blvd, Suite 101, Greenville, SC 29615 2018-07-23
1346726924 St. Francis Physician Services, Inc Internal Medicine 5 Hoke Smith Blvd, Greenville, SC 29615 2018-07-17
1558853101 Alexandra Michelle Taylor Audiologist 200 Patewood Dr Ste 400, Greenville, SC 29615 2018-05-30
1316466543 Mariah Hope Mosher Behavioral Analyst 7 Mckenna Commons Court, Greenvilee, SC 29615 2017-09-19
1326400896 Karen L Heaps Counselor 3150 S. Hwy 14, The Pelham Center, Greenville, SC 29615 2016-03-24
1134589013 Sharon Erk Technician, Other 2950 E.norths St, Greenville, OH 29615 2016-03-04
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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

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1801047808 Dagamac Enterprises LLC Clinic/Center 441 Hopkinsville St, Greenville, KY 42345-1101 2008-10-08
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1194292235 Adcare Rhode Island Clinic/Center 600 Putnam Pike Ste 7, Greenville, RI 02828-1487 2018-10-26
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1053719518 Genesis Counseling Services, LLC Clinic/Center 2320 E North St, Ste. Rr105, Greenville, SC 29607-1247 2014-12-16
1023345139 Pavillon Greenville Outpatient Services Clinic/Center 125 Pelham Commons Blvd, Greenville, SC 29615-4974 2009-11-10
1457417289 Addiction Treatment Resources, LLC Clinic/Center 4702 Wesley St Ste D, Greenville, TX 75401-5663 2006-12-28

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1922487610 Cornerstone Project Sc, LLC Clinic/Center 1919 Hampton St, Columbia, SC 29201-3535 2015-05-27
1912345893 Shoreline Behavioral Health Service Clinic/Center 626 Tyson Dr, Pawleys Island, SC 29585-6925 2013-06-12
1801131420 Recoverylife, LLC Clinic/Center 2246 Sumter St, Columbia, SC 29201-1932 2012-12-07
1437383403 Center for Behavioral Health South Carolina, Inc Clinic/Center 2301 Cosgrove Ave Ste F, North Charleston, SC 29405-7663 2009-05-06
1376691022 Saluda County Alcohol & Drug Abuse Comm Clinic/Center 204 N Ramage St, Saluda, SC 29138-1359 2007-01-08
1487665055 Fairfield Behavioral Health Services Clinic/Center 178 Us Highway 321 Bypass N., Winnsboro, SC 29180 2006-08-10
1053340273 Greenwood-edgefield-mccormick-abbeville Commission On Alcohol and Drug Clinic/Center 1420 Spring St, Greenwood, SC 29646-4057 2006-07-01
1972532075 Laurens County Commission On Alcohol and Drug Abuse Clinic/Center 219 Human Services Road, Clinton, SC 29325 2006-07-01
1972574101 The Ernest E. Kennedy Center Clinic/Center 306 Airport Dr, Moncks Corner, SC 29461-2629 2006-01-27
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Competitor

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City GREENVILLE
Zip Code 29615

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Dataset Information

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.

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