PINELANDS GROUP HOMES INC NPI 1710944087

NPI Information

NPI: 1710944087
Provider Name: PINELANDS GROUP HOMES, INC
Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
201 E LUKE AVE
SUMMERVILLE, SC
ZIP 29483
Phone: (843) 851-0079
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PINELANDS GROUP HOMES, INC is a residential treatment facility emotionally disturbed children in Summerville, SC. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. PINELANDS GROUP HOMES, INC NPI is 1710944087. The provider is registered as an organization entity type.

The provider's business location address is:

201 E LUKE AVE
SUMMERVILLE, SC
ZIP 29483-834
Phone: (843) 851-0079
Fax: (843) 873-1002

The provider's authorized official is Joette Kizer .
The authorized official title is Executive Director and has the following contact phone number (843) 851-0079.

The enumeration date for this NPI number is 4/28/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		SR-0008195001-CC1	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	927MXH	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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