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Organization
CHARLESTON ORPHAN HOUSE, INC
Active
Organization
CHARLESTON ORPHAN HOUSE, INC
Active
Other names
Carolina Youth Development Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BARBARA KELLEY DUNCAN (CHIEF EXECUTIVE OFFICER)
(843) 266-5222
Entity
Organization
Contact information
Practice address
5055 LACKAWANNA BLVD, NORTH CHARLESTON, SC 29405-4529
(843) 266-5200
(843) 266-5201
Mailing address
5055 LACKAWANNA BLVD, NORTH CHARLESTON, SC 29405-4529
(843) 266-5200
(843) 266-5201
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
SR-0008098001-CCI
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
938MXH
—
SC
Enumeration date
12/01/2006
Last updated
08/22/2020
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