| NPI | 1417419979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER TERLITSKY Owner/Sole Practitioner 864-915-5273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2019-04-03 |