| NPI | 1356053540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYREE S BUSH Owner/Administrator 803-776-4482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2024-03-11 |