Pinelands Group Home

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

SR0008195001CC1 Issued in SC

Legal business name

PINELANDS GROUP HOME

Practice address

201 E Luke Ave
Summerville, SC 29483-6834

Phone

(843) 851-0079

Fax

(843) 873-1002

NPI assigned

Jul 6, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Joette Kizer

Title

Ceo

Phone

(843) 851-0079

Specialties & licenses 1

Addresses

Tax ID family

Pinelands Group Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Pinelands Group Home, Inc.

  • Psychiatric Residential Treatment Facility
  • Summerville, SC
  • NPI 1770890485
  NPD tax ID
• Pinelands Group Homes, Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Summerville, SC
  • NPI 1710944087
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278374400000",
    "number": "1003128182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E LUKE AVE",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836834",
            "telephone_number": "843-851-0079",
            "fax_number": "843-873-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E LUKE AVE",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836834",
            "telephone_number": "843-851-0079",
            "fax_number": "843-873-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINELANDS GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-06",
        "last_updated": "2010-07-06",
        "status": "A",
        "authorized_official_last_name": "KIZER",
        "authorized_official_first_name": "JOETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-851-0079",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "SC",
            "license": "SR0008195001CC1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nellie Phoenix-McCoy, BT
• Andrea C Pilch, OTR/L
• Pillpack LLC
• Pineland Family Dental, P.a.
• Pineland Tidewater, PA
• Pinelands Group Home, Inc.
• Pinelands Group Homes, Inc
• Jessica Piper, MSW, LSWAIC
• James William Pippin, FNP
• Pisani Chiropractic

• Community/Behavioral Health Agency in Summerville, SC
• Providers in Summerville, SC by specialty
• Community/Behavioral Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.