NPI 1770829772

Sc Department of Juvenile Justice

Organisation Mental Illness Community Based Residential Treatment Facility Columbia, SC

Practice location

Address: 5000 Broad River Rd, Columbia, SC 29212-3532
Phone: (803) 896-8694
Mailing address: 5000 Broad River Rd, Columbia, SC 29210

Authorised official

Name: Jan Giesen
Title: Director of Social Work
Phone: (803) 582-9337

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence 4938 (SC)

Other Community Based Residential Treatment Facility, Mental Illness providers in South Carolina →

Registry record

NPI: 1770829772
Entity type: Organization
NPI issued: 19 Dec 2012
Record last updated: 19 Dec 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.