Organization
SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA ANN BLACK LMSW (PROGRAM MANAGER)
(803) 896-9029
Entity
Organization
Contact information
Practice address
5000 BROAD RIVER RD, COLUMBIA, SC 29212-3532
(803) 896-9029
Mailing address
5000 BROAD RIVER RD, COLUMBIA, SC 29212-3532
(803) 896-9029
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
006545
SC
Other
Enumeration date
12/17/2012
Last updated
12/17/2012
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