| NPI | 1316459811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAKA ABDUL MOUSTAFA-I CEO/Owner 803-446-5780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| 207R00000X Internal Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2017-10-25 |