| NPI | 1164481867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY GOODBAR Physician 864-676-9211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: SC 14711) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2011-02-03 |