| NPI | 1205354917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK GOLDSMITH Sole Proprietor 864-214-5492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: SC 5809) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2017-09-01 |