| NPI | 1427648765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDUL SHABAZZ Owner 843-302-2419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2021-01-20 |