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1528108073
SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE
COLUMBIA, SC
NPI
1528108073
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Entity Type
Organization
Authorized Contact
MIA L RICHARDSON
Medicaid Project Administrator
803-896-4751
Organization Subpart ?
No
Primary Taxonomy
103T00000X Psychologist
Enumeration Date
2007-02-07
Last Update Date
2020-08-22
Business Address
SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE
100 EXECUTIVE CENTER DR SANTEE BUILDING SUITE210
COLUMBIA, SC 29210-8407
Phone number: 803-896-4751
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Mailing Address
SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE
PO BOX 21069
COLUMBIA, SC 29221-1069
Phone number: 803-896-4751
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