| NPI | 1205484664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIKA GRIFFIN Director 803-320-7294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2019-08-29 |