| NPI | 1104643790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD ORBIA DEEL Administrator 864-304-5982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine |
| 251S00000X Community/Behavioral Health | |
| 363LA2200X Nurse Practitioner Adult Health | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |