# CHARLESTON ORPHAN HOUSE, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Carolina Youth Development Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306914056
- **Authorized official:** MS. BARBARA KELLEY DUNCAN (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (843) 266-5222

## Contact information

- **Practice address:** 5055 LACKAWANNA BLVD, NORTH CHARLESTON, SC 29405-4529
- **Practice address phone:** (843) 266-5200
- **Practice address fax:** (843) 266-5201
- **Mailing address:** 5055 LACKAWANNA BLVD, NORTH CHARLESTON, SC 29405-4529
- **Mailing address phone:** (843) 266-5200
- **Mailing address fax:** (843) 266-5201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | SR-0008098001-CCI | SC | Yes |

## Other

- **Enumeration date:** 12/01/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 938MXH | — | SC |