SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE

FOUNTAIN INN, SC
NPI1629119318
Other NameGENERATIONS MODERATE MANAGEMENT
Entity TypeOrganization
Authorized ContactMIA L RICHARDSON
Medicaid Project Administator
803-896-4751
Organization Subpart ?No
Primary Taxonomy322D00000X Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date2007-02-08
Last Update Date2020-08-22
Business Address
SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE
810 DUNKLIN BRIDGE ROAD
FOUNTAIN INN, SC 29644
Phone number: 864-243-5557
Mailing Address
SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE
PO BOX 21069
COLUMBIA, SC 29221-1069
Phone number: 803-896-4751
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