| NPI | 1386423960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORRIE L FARRAR Lisw Cp 843-254-1879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2024-10-22 |