| NPI | 1144001298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACEY REKKA SHAW Owner/Bcba 843-697-9894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2023-10-12 |