| NPI | 1578105979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE CIRIACO Authorized Official 864-350-6675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2020-11-05 |