| NPI | 1093285652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE WILES-SMITH Director 843-408-5971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2018-11-27 |