| NPI | 1124764568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE DENNIS Director 803-534-2328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2022-05-09 |