NPI | 1053524934 |
---|---|
Entity Type | Organization |
Authorized Contact | RANDY KEITH SANTANA Co Owner 843-744-1447 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SC OTP063) |
Enumeration Date | 2007-05-08 |
Last Update Date | 2020-08-22 |