South Carolina Department of Juvenile Justice
NPI 1629119318 · Emotionally Disturbed Childrens' Residential Treatment Facility · Fountain Inn, SC
South Carolina Department of Juvenile Justice is a Emotionally Disturbed Childrens' Residential Treatment Facility organization in Fountain Inn, SC (NPI 1629119318).
Provider details
- NPI number
- 1629119318
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Mia Richardson, Medicaid Project Administator(803) 896-4751
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Generations Moderate Management
Registry dates
- Enumerated
- 2007-02-08
- Last updated
- 2020-08-22
Frequently asked questions
- What is South Carolina Department of Juvenile Justice's NPI number?
- South Carolina Department of Juvenile Justice's National Provider Identifier (NPI) is 1629119318, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is South Carolina Department of Juvenile Justice?
- South Carolina Department of Juvenile Justice is classified in the NPPES registry as Emotionally Disturbed Childrens' Residential Treatment Facility (Residential Treatment Facilities).
- Where is South Carolina Department of Juvenile Justice located?
- South Carolina Department of Juvenile Justice's practice location on file with NPPES is 810 Dunklin Bridge Road, Fountain Inn, SC 29644.
- What is South Carolina Department of Juvenile Justice's phone number?
- The practice phone number listed in the NPPES registry for South Carolina Department of Juvenile Justice is (864) 243-5557.
- Who is the authorized official for South Carolina Department of Juvenile Justice?
- The authorized official listed on South Carolina Department of Juvenile Justice's NPPES record is Mia Richardson, Medicaid Project Administator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is South Carolina Department of Juvenile Justice's NPI active?
- Yes — South Carolina Department of Juvenile Justice's NPI (1629119318) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.