| NPI | 1285922336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER YOUNG Partner/Staff 803-335-1272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GP5785) |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: SC 22943) |
| 291U00000X Clinical Medical Laboratory (Licence: SC 42D2033880) | |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2013-06-18 |