| NPI | 1053179291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVER HUGHART Owner 803-949-6031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| 261QM0801X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-03-12 |
| Last Update Date | 2024-03-13 |