S.C Department of Juvenile Justice

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

3627 Issued in SC

Legal business name

S.C DEPARTMENT OF JUVENILE JUSTICE

Practice address

2112 Chandler Ave
Columbia, SC 29210-6204

Phone

(803) 896-9784

NPI assigned

Feb 7, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Jan Giesen, LIMSW

Title

Director of Social Work

Phone

(803) 896-4813

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1205175452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 CHANDLER AVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292106204",
            "telephone_number": "803-896-9784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 CHANDLER AVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292106204",
            "telephone_number": "803-896-9784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S.C DEPARTMENT OF JUVENILE JUSTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-07",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "GIESEN",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "DIRECTOR OF SOCIAL WORK",
        "authorized_official_telephone_number": "803-896-4813",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LIMSW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "SC",
            "license": "3627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Columbia, SC
• Providers in Columbia, 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 Feb 7, 2013; 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.