| NPI | 1245644020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A BASIE Therapist 803-493-7272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SC 4675) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2014-06-19 |