| NPI | 1265672844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE JAMES BRAVAKIS Programdirector/Lead Clinical Staff 864-906-1043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2009-02-23 |
| Last Update Date | 2009-02-23 |