INDIVIDUAL – NPI #1639415920
Residential Treatment Facility, Emotionally Disturbed Children

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.

INDIVIDUAL is a residential treatment facility located in COLUMBIA, SC. NPPES has assigned the NPI number 1639415920 to INDIVIDUAL on December 14, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 322D00000X from the Health Care Provider Taxonomy code set, which is classified as Residential Treatment Facility, Emotionally Disturbed Children.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for INDIVIDUAL below.

NPI Profile for
INDIVIDUAL

NPI Number
1639415920
Enumeration Date

(more than 13 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
INDIVIDUAL
Primary location
1725 SHIVERS RD
COLUMBIA, SC 29210-5413
Phone: (803) 896-5732 Fax: (803) 896-5723
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JAN GIESEN
DIRECTOR OF SOCIAL WORK
Phone: (803) 896-4813
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
322D00000X
- Residential Treatment Facility, Emotionally Disturbed Children (Primary)
SC 5322

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.