Boys Home of the South

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

SR0008004001 Issued in SC

Legal business name

BOYS HOME OF THE SOUTH

Practice address

10612 Augusta Rd
Belton, SC 29627-9246

Phone

(864) 243-3443

Fax

(864) 243-5743

NPI assigned

Jul 2, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Glynda Taylor Caddell

Title

Executive Director

Phone

(864) 243-3443

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Boys Home of the South2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Boys Home of the South

  • Community/Behavioral Health Agency
  • Belton, SC
  • NPI 1083910517
  NPD tax ID

Locations

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003845983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10612 AUGUSTA RD",
            "city": "BELTON",
            "state": "SC",
            "postal_code": "296279246",
            "telephone_number": "864-243-3443",
            "fax_number": "864-243-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10612 AUGUSTA RD",
            "city": "BELTON",
            "state": "SC",
            "postal_code": "296279246",
            "telephone_number": "864-243-3443",
            "fax_number": "864-243-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYS HOME OF THE SOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CADDELL",
        "authorized_official_first_name": "GLYNDA",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "864-243-3443"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "SC",
            "license": "SR0008004001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "968MXH",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jan Denean Banister, LPC, LPC/S
• Belton Comprehensive Dentistry
• Belton Emergency Medical Services Belton EMS
• April Lynn Black, LPN
• Bloom & Blossom LLC
• Boys Home of the South
• Cayleigh Jo Brookshire, PHARMD
• Spencer Brothers, PT, DPT
• Jarvis Brown
• Charity Hawkins Burdette, MSP, CCC-SLP

• Emotionally Disturbed Childrens' Residential Treatment Facility in Belton, SC
• Providers in Belton, SC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.