| NPI | 1043504806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATREACE BROWN-BAKER Owner 843-379-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: SC 11727) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: SC 11727) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2022-07-21 |