| NPI | 1013482769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNA AMANDA JEFFERSON Director Of Clinical Operations 803-743-2753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2018-10-09 |