NPI | 1114489317 |
---|---|
Entity Type | Organization |
Authorized Contact | TREVIN COLCLOUGH Owner/Clinical Director 803-795-8604 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Additional Taxonomies | 101Y00000X Counselor |
261QM0801X | |
Enumeration Date | 2019-04-05 |
Last Update Date | 2019-05-29 |