| NPI | 1497817613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM T. O'CONNOR Executive Director 843-423-8292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC OTP-004) |
| Additional Taxonomies | 251S00000X (Licence: SC OTP-004) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |