| 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 | Community/behavioral Health |
| Location | 5055 Lackawanna Blvd, North Charleston, South Carolina |
| Authorized Official Name and Position | Barbara Kelley Duncan (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8432665200 |
| 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 | 1437422839 |
|---|---|
| Provider Enumeration Date | 02/15/2012 |
| Last Update Date | 02/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437422839 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 251340133 (South Carolina) | Primary |
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