| NPI | 1467019778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANTLEE SHAE NOLAND Director Of Regulatory Compliance 803-635-2154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2022-01-25 |