| NPI | 1346827862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD CONYERS O'BRYAN Incorporator 843-323-0833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2022-02-01 |