| NPI | 1215665047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY COPLIN Executive Director 803-220-7288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2022-08-10 |
| Last Update Date | 2022-08-10 |