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South Carolina Department of Juvenile Justice

Emotionally Disturbed Childrens' Residential Treatment Facility in Charleston, SC · enumerated 2007 · authorized official Mia Richardson, Medicaid Project Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1245370097

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Registry record

Entity type Organization (Type 2)
Legal business name South Carolina Department of Juvenile Justice
Other name <Unavail>
Practice address 4360 Headquarters Rd, Charleston, SC, 29405
Phone (803) 740-6148
Fax (803) 740-1626
Enumeration date Feb 8, 2007
Last updated in NPPES Aug 22, 2020

Taxonomy & classification

322D00000X Emotionally Disturbed Childrens' Residential Treatment Facility Residential Treatment Facilities Primary

Authorized official

Name Mia Richardson
Title Medicaid Project Administrator
Phone (803) 896-4751

Other identifiers

Identifier Type State Issuer
DJJ054 Medicaid SC -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What type of organization is South Carolina Department of Juvenile Justice?
South Carolina Department of Juvenile Justice is registered in NPPES as a Emotionally Disturbed Childrens' Residential Treatment Facility (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-22.