| NPI | 1215673256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS AZEH Incorporator 843-460-4292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2025-06-01 |