| NPI | 1275205494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT OLIVERIO VP 843-724-2903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology Addiction Psychiatry |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2021-10-05 |