| NPI | 1225751068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE KEEL Director Of Operations 864-520-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2026-03-10 |