| NPI | 1043320146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUENARRL KEITH Executive Minister 843-993-5534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-04-20 |