| NPI | 1093229700 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | NICKIE CHALONDA ROGERS Owner 803-774-6892  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 6260)  | 
| Additional Taxonomies | 251S00000X Community/Behavioral Health | 
| Enumeration Date | 2017-11-17 | 
| Last Update Date | 2025-01-10 |