DJJ GREENVILLE GROUP HOME
NPI 1710027578
Residential Treatment Facility, Emotionally Disturbed Children in Greenville, SC

Q: What is South Carolina Department Of Juvenile Justice's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

Active since February 08, 2007

423 VARDRY ST, GREENVILLE, SC 29601(864) 233-5574(864) 233-7526 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Djj Greenville Group Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DJJ GREENVILLE GROUP HOME (NPI 1710027578) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Greenville, South Carolina and active in the NPI registry since February 2007. The organization lists Mia L Richardson, Medicaid Project Administrator, as its authorized official.

NPPES Registry Identity

NPI1710027578

Entity TypeOrganization

Primary Taxonomy322D00000X

Legal Business NameSOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE

Location Address423 VARDRY STGreenville, SC 29601-3307

Mailing AddressPo Box 21069Columbia, SC 29221-1069 · (803) 896-4751 · Fax (803) 896-8473

Phone(864) 233-5574

Fax(864) 233-7526

Organization SubpartNo

Authorized OfficialMia L RichardsonMedicaid Project Administrator · (803) 896-4751

Enumeration DateFebruary 8, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1710027578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities

Taxonomy Code322D00000X

Definition

A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

423 VARDRY ST, Greenville, SC 29601

Open in Google Maps ↗

Other Names 1

Other NameDjj Greenville Group Home

Other Identifiers 1

MedicaidDJJ058SC

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South Carolina Department Of Juvenile Justice's NPI number?

The NPI number for South Carolina Department Of Juvenile Justice is 1710027578. It was assigned to this organization in the NPPES registry on February 8, 2007. The provider is also known as Djj Greenville Group Home.

Where is South Carolina Department Of Juvenile Justice located?

South Carolina Department Of Juvenile Justice is located at 423 Vardry St, Greenville, SC 29601. The listed phone number is (864) 233-5574.

What is South Carolina Department Of Juvenile Justice's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

When was this NPI record last updated?

The NPPES record for South Carolina Department Of Juvenile Justice was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.