Southeastern Children'S Home

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

SOUTHEASTERN CHILDREN'S HOME

Practice address

115 Childrens Way
Duncan, SC 29334-9769

Phone

(864) 439-0259

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert C. Kimberly

Title

Executive Director

Phone

(864) 439-0259

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Southeastern Children'S Home Inc3 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.

• Southeastern Children'S Home, Inc.

  • Voluntary or Charitable Agency
  • Duncan, SC
  • NPI 1275848640
  NPD tax ID
• Southeastern Children'S Home, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Duncan, SC
  • NPI 1982634721
  NPD tax ID

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104977735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CHILDRENS WAY",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293349769",
            "telephone_number": "864-439-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CHILDRENS WAY",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293349769",
            "telephone_number": "864-439-0259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN CHILDREN'S HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIMBERLY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "864-439-0259",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "978MXH",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "920MXH",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Elizabeth Simpson
• James Kirkland Smith, MSW
• Joanna Smith, FNP-BC
• Tracy Y Smith
• South Carolina Podiatric Physicians and Surgeons Group, LLC
• Southeastern Children'S Home, Inc.
• Southeastern Children'S Home, Inc.
• Alexis Sparks
• Spartanburg County School District No. 5
• Spartanburg Medical Center

• Emotionally Disturbed Childrens' Residential Treatment Facility in Duncan, SC
• Providers in Duncan, 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.