| Carolina Youth Development Center | |
|
5055 Lackawanna Blvd North Charleston SC 29405-4529 | |
| (843) 266-5200 | |
| (843) 266-5201 |
| Full Name | Carolina Youth Development Center |
|---|---|
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
| Location | 5055 Lackawanna Blvd, North Charleston, South Carolina |
| Authorized Official Name and Position | Barbara Kelley Duncan (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8432665222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Youth Development Center 5055 Lackawanna Blvd North Charleston SC 29405-4529 Ph: (843) 266-5200 | Carolina Youth Development Center 5055 Lackawanna Blvd North Charleston SC 29405-4529 Ph: (843) 266-5200 |
| NPI Number | 1366503443 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366503443 | NPI | - | NPPES |
| 992MXH | Medicaid | SC |
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