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General NPI Number Information
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NPI Number | 1114068301
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Entity Type | Organization
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Legal Business Name | TURNING POINT BOYS HOME, INC
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 3184 HUNTS MILL ROAD
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City | CHESTERFIELD
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State | SC
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Zip | 29709
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Country | US
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Telephone | 843-498-7077
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Fax | 843-498-7077
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Provider Business Mailing Address
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Address Line | 3184 HUNTS MILL ROAD
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City | CHESTERFIELD
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State | SC
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Zip | 29709
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Country | US
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Telephone | 843-498-7077
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Fax | 843-498-7077
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. BRYAN ONEAL JACKSON
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Credential | DO
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Telephone | 843-858-4425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | CR1002414001GH
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License Number State | SC
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