South Carolina Department of Juvenile Justice

NPI #1891835799 in Clinton, South Carolina

Provider Information

NPI Number
1891835799
Entity Type
Organization
Organization Name
South Carolina Department of Juvenile Justice
Primary Specialty
Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date
Feb 8, 2007
Last Updated
Aug 22, 2020

Practice Location

Address
20238 HIGHWAY 72 E
ZIP Code
29325-4442
Phone
(864) 833-4505

Authorized Official

Name
MS. MIA L RICHARDSON
Title
MEDICAID PROJECT ADMINISTRATOR
Phone
(803) 896-4751

Specialties & Taxonomy Codes

Specialty
Residential Treatment Facility, Emotionally Disturbed Children

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