CLEAR SKYE MEDICAL HOLDINGS, LLC (NPI# 1821561788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821561788 |
| Entity Type | Organization |
| Organization Name | CLEAR SKYE MEDICAL HOLDINGS, LLC |
| Practice Address |
1035 Medical Ridge Rd Clinton SC 29325-4542 |
| Practice Telephone | 8645472089 |
| Practice Fax Number | 8645472086 |
| Mailing Telephone | 8645472089 |
| Mailing Fax Number | 8645472086 |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2020-07-20 |
| Authorized Official Name | DR. GAJENDRA BAFNA (CO OWNER) |
| Authorized Official Telephone | 8646317371 |
| Authorized Official Credential | R PH |
| Is Organization Subpart | Y |
| Parent Organization Name | CLEAR SKYE MEDICAL HOLDINGS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Street Address |
1035 MEDICAL RIDGE RD |
| City | CLINTON |
| State | SC |
| Zip Code | 29325-4542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255756797 | Foot Clinic of South Carolina, LLC | Podiatrist | 1035 Medical Ridge Rd, Clinton, SC 29325-4542 | 2014-02-20 |
| 1316594724 | Akila Davis Boozer | Nurse Practitioner | 1035 Medical Ridge Rd, Clinton, SC 29325-4542 | 2019-08-20 |
| 1922577758 | Patricia Ann Gordon | Counselor | 1035 Medical Ridge Rd, Clinton, SC 29325-4542 | 2018-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295353100 | Mason Paige Gambrell | Student in an Organized Health Care Education/Training Program | 107 Shellcreek Ct, Clinton, SC 29325 | 2020-07-07 |
| 1386207975 | Tammy Binger | Registered Nurse | 22725 U.S. 76, Clinton, SC 29325 | 2019-04-18 |
| 1154828945 | Lillian Smith | Physical Therapy Assistant | Nhc Clinton, 304 Jacobs Highway, Clinton, SC 29325 | 2018-04-09 |
| 1134519366 | Nora Pace | Specialist/Technologist | 18132 Hwy 72 E, Clinton, SC 29325 | 2015-01-26 |
| 1497186845 | John M. Griz | Orthopaedic Surgery | 22971 Hwy 76e, Clinton, SC 29325 | 2013-12-11 |
| 1992131171 | Sharon Kay Stoia | Occupational Therapist | 600 Plaza Circle, Clinton, SC 29325 | 2013-09-19 |
| 1578800256 | Hayes Ambulance Service LLC | Ambulance | 2143 Torrington Road, Clinton, SC 29325 | 2013-01-14 |
| 1083943518 | Margaret Estelle Shreve | Chiropractor | 209 Musgrove St, Clinton, SC 29325 | 2009-12-11 |
| 1750556213 | Piedmont Regional Urology | Urology | 300 Plantation Plaza, Suite F, Clinton, SC 29325 | 2008-04-25 |
| 1285821587 | Assisted Living Concepts Inc | Assisted Living Facility | 939 Springdale Drive, Clinton, SC 29325 | 2007-10-01 |
| Find all providers in zip 29325 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161091 | New Destiny Treatment Center, Inc. | Substance Abuse Rehabilitation Facility | 6694 Taylor Rd, Clinton, OH 44216-9201 | 2020-07-09 |
| 1952800104 | Freedom House Inc. | Substance Abuse Rehabilitation Facility | 2004 Route 31 North, Suite 2, Clinton, NJ 08809 | 2018-02-02 |
| 1598215386 | Carol Cruz | Substance Abuse Rehabilitation Facility | 23 Elmwood Way, Clinton, CT 06413-1508 | 2016-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972143485 | Landmark Recovery of Columbia LLC | Substance Abuse Rehabilitation Facility | 140 Flora Dr, Columbia, SC 29223-5814 | 2020-01-13 |
| 1457800310 | Summit Bhc Cameron, LLC | Substance Abuse Rehabilitation Facility | 5401 Netherby Ln Ste 402, North Charleston, SC 29420-7363 | 2016-10-03 |
| 1235686833 | Summit Bhc Cameron, LLC | Substance Abuse Rehabilitation Facility | 499 Wild Hearts Road, Cameron, SC 29030 | 2016-09-01 |
| 1659776664 | Katonya Alford | Substance Abuse Rehabilitation Facility | 505 N 5th Ave, Dillon, SC 29536-2815 | 2014-11-03 |
| 1609008713 | Steve Austin Facility of Charleston | Substance Abuse Rehabilitation Facility | 1383 Remount Rd, North Charleston, SC 29406-3345 | 2009-08-23 |
| 1063681591 | Givebac Incorporated | Substance Abuse Rehabilitation Facility | 1481 Ted Melton Rd, Chesterfield, SC 29709-6313 | 2008-02-28 |
| 1134158231 | Horry County Comm On Alcohol & Drug Abuse | Substance Abuse Rehabilitation Facility | 2404 Wise Rd, Conway, SC 29526-5521 | 2006-07-01 |
| 1770572448 | Tri-county County Commission On Alcohol and Drug Abuse | Substance Abuse Rehabilitation Facility | 910 Cook Rd, Orangeburg, SC 29118-2124 | 2005-10-17 |
| 1487653606 | Beaufort County Alcohol & Drug Abuse Department | Substance Abuse Rehabilitation Facility | 1905 Duke St, Ste 270, Beaufort, SC 29902-4403 | 2005-07-19 |
| 1861496234 | Department of Alcohol and Other Drug Abuse Services | Substance Abuse Rehabilitation Facility | 5 Charleston Center Dr, Charleston, SC 29401-1162 | 2005-06-13 |
| Find all providers with the same taxonomy | ||||
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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.