| NPI | 1093096695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE BACOTE Owner/Director 843-496-6454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SC 4782) |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2011-09-09 |