| NPI | 1023411931 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SURYANI SUNDJOJO CAPPS Executive Director 843-524-2256  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health | 
| Enumeration Date | 2014-10-06 | 
| Last Update Date | 2014-10-06 |