| NPI | 1528822178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CIARA MONIQUE SUROS Clinician 803-306-2458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-02-13 |
| Last Update Date | 2024-11-12 |