Organization
PINELANDS GROUP HOMES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOETTE KIZER (EXECUTIVE DIRECTOR)
(843) 851-0079
Entity
Organization
Contact information
Practice address
201 E LUKE AVE, SUMMERVILLE, SC 29483-6834
(843) 851-0079
(843) 873-1002
Mailing address
201 E LUKE AVE, SUMMERVILLE, SC 29483-6834
(843) 851-0079
(843) 873-1002
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
SR-0008195001-CC1
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
927MXH
—
SC
Enumeration date
04/28/2006
Last updated
08/22/2020
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