| NPI | 1255703575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY FORD Executive Director 843-343-4188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SC SC 1449) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2015-11-18 |