| NPI | 1114279403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORETHA HICKSON Human Services Specialist 1 843-317-4073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2012-10-10 |