| NPI | 1427606409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE L GIBSON Owner 803-983-6735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2019-09-03 |