Organization
SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE
Active
Other names
Camp Bennettsville I
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MIA L RICHARDSON (MEDICAID PROJECT ADMINISTRATOR)
(803) 896-4751
Entity
Organization
Contact information
Practice address
620 MARLBORO RD, BENNETTSVILLE, SC 29512-7733
(843) 479-0420
(843) 479-0840
Mailing address
PO BOX 21069, COLUMBIA, SC 29221-1069
(803) 896-4751
(803) 896-8473
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DJJ048
—
SC
Enumeration date
02/08/2007
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us