| NPI | 1235592072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA JEAN JOHNSTON Owner 843-696-0819 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-03-30 |