| NPI | 1417601980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENNDY DUPKOSKI Counselor 803-210-7422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2022-02-06 |