| NPI | 1023721313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TITA JOHNSON Owner 843-968-2750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2023-01-02 |
| Last Update Date | 2023-01-02 |