Organization
SOUTHEASTERN CHILDREN'S HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT C. KIMBERLY (EXECUTIVE DIRECTOR)
(864) 439-0259
Entity
Organization
Contact information
Practice address
115 CHILDRENS WAY, DUNCAN, SC 29334-9769
(864) 439-0259
Mailing address
115 CHILDRENS WAY, DUNCAN, SC 29334-9769
(864) 439-0259
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
920MXH
—
SC
05
—
978MXH
—
SC
Enumeration date
01/12/2007
Last updated
08/22/2020
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