| NPI | 1184321556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA JONES FULTON Owner 843-401-9217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 1041C0700X Social Worker, Clinical | |
| 251B00000X Case Management | |
| 251S00000X | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2023-02-15 |