SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE


Address: 60 Honeybee Island Rd, Seabrook, SC 29940-3306
Phone: 8438462127

SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE (NPI# 1578603791) 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) 1578603791
Entity Type Organization
Organization Name SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE
Other Organization Name DJJ BEAUFORT MARINE INSTITUTE
Practice Address 60 Honeybee Island Rd
Seabrook
SC 29940-3306
Mailing Address P.o. Box 21069
Columbia
SC 29221-1069
Practice Telephone 8438462127
Practice Fax Number 8438464147
Mailing Telephone 8038964751
Mailing Fax Number 8038968473
Enumeration Date 2007-02-07
Last Update Date 2020-08-22
Authorized Official Name MS. MIA L RICHARDSON (MEDICAID PROJECT ADMINISTRATOR)
Authorized Official Telephone 8038964751
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 322D00000X Residential Treatment Facility, Emotionally Disturbed Children Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
SC DJJ063 05

Other Provider/Organization Names

Other Name Type Code
DJJ Beaufort Marine Institute Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1710027578 South Carolina Department of Juvenile Justice Residential Treatment Facility, Emotionally Disturbed Children 423 Vardry St, Greenville, SC 29601-3307 2007-02-08
1083755615 South Carolina Department of Juvenile Justice Residential Treatment Facility, Emotionally Disturbed Children 1600 Shivers Rd, Columbia, SC 29210-5429 2007-02-08
1194866723 South Carolina Department of Juvenile Justice Residential Treatment Facility, Emotionally Disturbed Children 1741 Shivers Rd, Columbia, SC 29210-5413 2007-02-08
1851431779 South Carolina Department of Juvenile Justice Residential Treatment Facility, Emotionally Disturbed Children 620 Marlboro Rd, Bennettsville, SC 29512-7733 2007-02-08
1578604195 South Carolina Department of Juvenile Justice Residential Treatment Facility, Emotionally Disturbed Children 742 T Bishop Rd, Jonesville, SC 29353-2342 2007-02-08
1891835799 South Carolina Department of Juvenile Justice Residential Treatment Facility, Emotionally Disturbed Children 20238 Highway 72 E, Clinton, SC 29325-4442 2007-02-08
1710027644 South Carolina Department of Juvenile Justice Residential Treatment Facility, Emotionally Disturbed Children 5300 Broad River Rd, Columbia, SC 29212-3539 2007-02-08
1821138678 South Carolina Department of Juvenile Justice Residential Treatment Facility, Emotionally Disturbed Children 2381 Campbell Lake Rd, Patrick, SC 29584-4016 2007-02-08
1629119318 South Carolina Department of Juvenile Justice Residential Treatment Facility, Emotionally Disturbed Children 810 Dunklin Bridge Road, Fountain Inn, SC 29644 2007-02-08
1871633081 South Carolina Department of Juvenile Justice Residential Treatment Facility, Emotionally Disturbed Children 1590 East Ccc Road, Highway 17 South, Georgetown, SC 29440 2007-02-07

Office Location

Street Address 60 HONEYBEE ISLAND RD
City SEABROOK
State SC
Zip Code 29940-3306

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225306707 Barbara Laughlin Helms Speech-Language Pathologist 21 Winterdale Drive, Seabrook, SC 29940-0512 2011-12-12
1598004400 Joyce Denese Mills Home Health 19 Wild Flower Ln, Seabrook, SC 29940-2503 2013-02-13
1902392491 Eric Talus Dentist 211 Paige Point Rd, Seabrook, SC 29940-2737 2018-07-08
1003447061 Tdk Transporting LLC Non-emergency Medical Transport (VAN) 23 Benjamin Smalls Rd, Seabrook, SC 29940-3202 2020-01-29
1073753968 Erin Duncan Speech-Language Pathologist 11 Stagecoach Rd, Seabrook, SC 29940-3518 2009-03-05

Providers in the same city

NPI Name Taxonomy Address Enumeration
1376144303 Stephanie Renee Knight Nurse Practitioner 4326 Egret Dr, Seabrook, TX 77586-2557 2020-11-05
1578173779 Seabrook Therapy & Assessment Center Pllc Counselor 2206 Acadiana Ct, Seabrook, TX 77586-3385 2020-08-04
1255949129 Northstar Psychiatric Health Pllc Nurse Practitioner 380 Lafayette Rd Unit 11-121, Seabrook, NH 03874-4551 2020-07-16
1124644943 Gulf Coast Clinic of Chiropractic LLC Chiropractor 2825 Nasa Pkwy, Seabrook, TX 77586-3215 2020-06-17
1841812377 Laya Allene Janota Registered Nurse 2555 N Repsdorph Rd Apt 933, Seabrook, TX 77586-6524 2020-05-06
1659902682 John James Mustachia IIi Registered Nurse 2602 Hollybrook Dr, Seabrook, TX 77586-2848 2020-01-29
1003447061 Tdk Transporting LLC Non-emergency Medical Transport (VAN) 23 Benjamin Smalls Rd, Seabrook, SC 29940-3202 2020-01-29
1962047753 Patricia Heflin Dietitian, Registered 2930 Sea Channel Dr, Seabrook, TX 77586-1640 2019-11-15
1356986863 City of Seabrook Ambulance 1850 East Meyer Rd, Seabrook, TX 77586-2290 2019-11-08
1619528486 Comprehensive Treatment Solutions Social Worker 2530 De Four Trce, Seabrook, TX 77586-3342 2019-09-24
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Taxonomy Information

Taxonomy Code 322D00000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Emotionally Disturbed Children

Taxonomy Definition

A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment.
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1235797812 Wise Care Services, LLC Residential Treatment Facility, Emotionally Disturbed Children 1435 Deberry Blvd, Florence, SC 29501-5601 2019-05-30
1366937021 Doors To Freedom Residential Treatment Facility, Emotionally Disturbed Children 1317m N Main St # 263, Summerville, SC 29483-7307 2018-06-26
1205297967 Potter's House Palmetto, Inc. Residential Treatment Facility, Emotionally Disturbed Children 104 E Berry St, Lincolnville, SC 29485-7204 2016-03-09
1710342522 New Directions Residential Treatment Facility, Emotionally Disturbed Children 3685 Travertine Dr, Lancaster, SC 29720-6934 2015-12-21
1609219906 Billie Hardee Home for Boys Residential Treatment Facility, Emotionally Disturbed Children 1120 Timmonsville Hwy, Darlington, SC 29532-9998 2013-04-17
1205175452 S.c Department of Juvenile Justice Residential Treatment Facility, Emotionally Disturbed Children 2112 Chandler Ave, Columbia, SC 29210-6204 2013-02-07
1477820504 Cherokee Creek Boys School Residential Treatment Facility, Emotionally Disturbed Children 198 Cooper Rd, Westminster, SC 29693-3309 2011-11-17
1124260427 Broadstep Academy-sc, Inc. Residential Treatment Facility, Emotionally Disturbed Children 1370 N Williamsburg County Hwy, Kingstree, SC 29556-7027 2009-04-01
1235325242 New Beginnings of Charleston Inc. Residential Treatment Facility, Emotionally Disturbed Children 716 W Front St, Lincolnville, SC 29485-7112 2007-09-24
1639399553 Orangeburg Attention Homes, Inc. Residential Treatment Facility, Emotionally Disturbed Children 155 Wall St Rm 16, Orangeburg, SC 29115-5404 2007-04-26
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Competitor

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City SEABROOK
Zip Code 29940

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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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