| NPI | 1275822249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE RALEY Owner 803-764-3555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2024-01-04 |