Pinelands Group Homes, Inc

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

SR-0008195001-CC1 Issued in SC

Legal business name

PINELANDS GROUP HOMES, INC

Practice address

201 E Luke Ave
Summerville, SC 29483-6834

Phone

(843) 851-0079

Fax

(843) 873-1002

NPI assigned

Apr 28, 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

Ms. Joette Kizer

Title

Executive Director

Phone

(843) 851-0079

Specialties & licenses 1

Addresses

Other identifiers 1

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

  • Community/Behavioral Health Agency
  • Summerville, SC
  • NPI 1003128182
  NPD tax ID
• Pinelands Group Home, Inc.

  • Psychiatric Residential Treatment Facility
  • Summerville, SC
  • NPI 1770890485
  NPD tax ID

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710944087",
    "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 HOMES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIZER",
        "authorized_official_first_name": "JOETTE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "843-851-0079",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "SC",
            "license": "SR-0008195001-CC1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "927MXH",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pinelands Group Home
• Pinelands Group Home, Inc.
• Jessica Piper, MSW, LSWAIC
• James William Pippin, FNP
• Pisani Chiropractic (AlignLife of Wescott)
• Kaitlin Pisani, DO
• Michael Pisani, D.C.

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