Organization
SLEEPY HOLLOW YOUTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY A. SPATEHOLTS M.ED. (CEO)
(843) 200-4268
Entity
Organization
Contact information
Practice address
122 JO FURR LN, SUMMERVILLE, SC 29485-7709
(843) 851-8028
(843) 572-6418
Mailing address
PO BOX 1202, GOOSE CREEK, SC 29445-1202
(843) 200-4268
(843) 572-6418
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
SR0008207001GH
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
925 MXH
—
SC
Enumeration date
04/21/2006
Last updated
08/22/2020
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