| NPI | 1114455615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA CULBERTSON Owner 864-710-4723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 3474) |
| Additional Taxonomies | 251S00000X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2021-12-02 |