| NPI | 1518023076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES FURTICK Director 803-516-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: SC 4068) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2023-04-27 |