| NPI | 1407657877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA PHILLIPS Owner 803-200-1053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2025-03-21 |
| Last Update Date | 2025-03-21 |