NPIMap

Organization Active NPI

Pinelands Group Home, Inc.

  • Psychiatric Residential Treatment Facility
  • Summerville, SC
National Provider Identifier
1770890485
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
RTF-0026 Issued in SC
Legal business name
PINELANDS GROUP HOME, INC.
Practice address
201 E Luke Ave
Summerville, SC 29483-6834
Phone
(843) 851-0079
NPI assigned
Sep 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Authorized official

Name
Ms. Joette Kizer
Title
Ceo
Phone
(843) 851-0079

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X RTF-0026 SC Primary

Addresses

Primary practice location

201 E Luke Ave
Summerville, SC 29483-6834

Mailing address

201 E Luke Ave
Summerville, SC 29483-6834

National Provider Directory

National Provider Directory
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.

NPI Registry JSON

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283385600000",
    "number": "1770890485",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINELANDS GROUP HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-02",
        "last_updated": "2010-09-02",
        "status": "A",
        "authorized_official_last_name": "KIZER",
        "authorized_official_first_name": "JOETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-851-0079",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "SC",
            "license": "RTF-0026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.