| NPI | 1356831432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIUS HENDERSON Director Of Quality Assurance 803-565-9742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2020-06-17 |