SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE (NPI# 1851431779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851431779 |
| Entity Type | Organization |
| Organization Name | SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE |
| Other Organization Name | CAMP BENNETSVILLE II |
| Practice Address |
620 Marlboro Rd Bennettsville SC 29512-7733 |
| Mailing Address |
Po Box 21069 Columbia SC 29221-1069 |
| Practice Telephone | 8434790420 |
| Practice Fax Number | 8434790840 |
| Mailing Telephone | 8038964751 |
| Mailing Fax Number | 8038968473 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. MIA L RICHARDSON (MEDICAID PROJECT ADMINISTRATOR) |
| Authorized Official Telephone | 8038964751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | DJJ049 | 05 |
| Other Name | Type Code |
|---|---|
| Camp Bennetsville II | Other Name - Individual/Organization |
| 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 |
| 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 |
| 1578603791 | South Carolina Department of Juvenile Justice | Residential Treatment Facility, Emotionally Disturbed Children | 60 Honeybee Island Rd, Seabrook, SC 29940-3306 | 2007-02-07 |
| Street Address |
620 MARLBORO RD |
| City | BENNETTSVILLE |
| State | SC |
| Zip Code | 29512-7733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407997034 | South Carolina Department of Juvenile Justice | Residential Treatment Facility, Emotionally Disturbed Children | 620 Marlboro Rd, Bennettsville, SC 29512-7733 | 2007-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861841371 | Anna Paige Paul | Counselor | 1035 Cherau St, Bennettsville, SC 29512 | 2016-06-06 |
| 1821468679 | Kristen Dana Oliver | Social Worker | 1035 Cherow St., Bennettsville, SC 29512 | 2015-10-05 |
| 1285022749 | 3-points Coastal Care,llc | Community/Behavioral Health | 1300 West Main St, Bennettsville, SC 29512 | 2015-01-06 |
| 1437572328 | Terri Cardenas Woodham | Pharmacist | 336 Highway 9 West, Bennettsville, SC 29512 | 2014-01-28 |
| 1851712533 | Amy Kessler | Pharmacist | 336 Hwy 9 West, Bennettsville, SC 29512 | 2013-12-23 |
| 1346677184 | Daniel Louis Lockamy | Counselor | 284 Tatum Rd, Bennettsville, SC 29512 | 2013-10-10 |
| 1164772596 | Melissa Irene Pletan | Pharmacist | 1085 Cottingham Blvd, Ste 3, Bennettsville, SC 29512 | 2012-09-13 |
| 1730440769 | Cigna Onsite Health LLC | Non-Pharmacy Dispensing Site | 2094 Marlboro Rd, Bennettsville, SC 29512 | 2012-06-06 |
| 1649572710 | Ingram Health Service/manna House.inc | Case Management | 211 N Market Street, Bennettsville, SC 29512 | 2010-11-23 |
| 1952564387 | Gregory Wayne Alford | Community Health Worker | 610 State Street Ext, Bennettsville, SC 29512 | 2008-07-07 |
| Find all providers in zip 29512 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407997034 | South Carolina Department of Juvenile Justice | Residential Treatment Facility, Emotionally Disturbed Children | 620 Marlboro Rd, Bennettsville, SC 29512-7733 | 2007-02-08 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | BENNETTSVILLE |
| Zip Code | 29512 |
Please comment or provide details below to improve the information on SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE.
| 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.