| NPI | 1518619147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALETA FINKLEY Manager 843-902-4795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 251B00000X Case Management | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-01-25 |