| NPI | 1205204138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CABANISS Owner 843-817-7077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: NC 001002367) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-09-09 |