| NPI | 1235351008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS FULCHER Owner 843-676-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: SC R 43406) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |