| NPI | 1114619590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOBY MATTHEW SHIPMAN Chief Executive Officer, 843-998-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2023-05-25 |