| NPI | 1275126690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PORTIA MACK Director 803-369-9848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Additional Taxonomies | 251S00000X |
| 251T00000X PACE Provider Organization | |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2021-02-17 |