| NPI | 1467725614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERBERT ADDISON Director 803-629-7540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2012-03-22 |