SC Department of Juvenile Justice

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

4938 Issued in SC

Legal business name

SC DEPARTMENT OF JUVENILE JUSTICE

Practice address

5000 Broad River Rd
Columbia, SC 29212-3532

Phone

(803) 896-8694

NPI assigned

Dec 19, 2012

Last updated

Dec 19, 2012By 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

Mrs. Jan Giesen, LISW-CP AP

Title

Director of Social Work

Phone

(803) 582-9337

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355875200000",
    "number": "1770829772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BROAD RIVER RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29210",
            "telephone_number": "803-896-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 BROAD RIVER RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292123532",
            "telephone_number": "803-896-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SC DEPARTMENT OF JUVENILE JUSTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-19",
        "last_updated": "2012-12-19",
        "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": "803-582-9337",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LISW-CP AP"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "SC",
            "license": "4938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SC Anesthesiology LLC
• SC Behavior Solutions, LLC
• SC DDSN (Midlands Center)
• SC Department of Health & Environmental Control
• SC Department of Health and Human Services
• SC Department of Juvenile Justice
• SC Dept of Disabilities & Special Needs
• SC Dept of Disabilities & Special Needs
• SC Dept of Disabilities & Special Needs
• SC Dept of Disabilities & Special Needs

• Mental Illness Community Based Residential Treatment Facility in Columbia, SC
• Providers in Columbia, SC by specialty
• Mental Illness Community Based Residential Treatment Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.