| NPI | 1033516067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH H ANAGNOS Area Director 843-974-4686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SC 1043534191) |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2014-11-19 |