| NPI | 1205979630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES EDWARD JENKINS Owner 843-740-6999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 9864) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-04-07 |