| NPI | 1083937601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA ODONNELL Owner 843-810-2455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: SC 8395) |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2011-03-02 |