| NPI | 1033783592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDALL DORIE Clinical Director 864-295-1280 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 207QA0401X Family Medicine Addiction Medicine | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2021-07-27 |