| NPI | 1114068301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN ONEAL JACKSON Director 843-858-4425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: SC CR1002414001GH) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2008-07-17 |