| NPI | 1295470904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA D. MULDROW Owner 803-579-8558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2023-08-03 |