# SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790021970
- **Authorized official:** MS. CYNTHIA ANN BLACK LMSW (PROGRAM MANAGER)
- **Authorized official phone:** (803) 896-9029

## Contact information

- **Practice address:** 5000 BROAD RIVER RD, COLUMBIA, SC 29212-3532
- **Practice address phone:** (803) 896-9029
- **Mailing address:** 5000 BROAD RIVER RD, COLUMBIA, SC 29212-3532
- **Mailing address phone:** (803) 896-9029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | 006545 | SC | Yes |

## Other

- **Enumeration date:** 12/17/2012
- **Last updated:** 12/17/2012