| NPI | 1104664465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL NORMAN Member 864-877-7025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-07-19 |
| Last Update Date | 2024-07-19 |