| NPI | 1487928313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | UT UYEN N VANHOOGEN Owner 843-267-4684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SC 5368) |
| Enumeration Date | 2012-02-23 |
| Last Update Date | 2013-04-16 |