| NPI | 1235653395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARISSA M OWENS Chief Executive Officer 843-633-3895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 6308) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2017-12-12 |