| NPI | 1285110957 |
|---|---|
| Doing Business As | MOOKIES PLACE YOUTH AND FAMILY PROGRAM |
| Entity Type | Organization |
| Authorized Contact | LETISHA LYNN SMALLS President 803-285-8589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 251300000X Local Education Agency (LEA) | |
| 251B00000X Case Management | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2019-03-15 |