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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