| NPI | 1578220943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA ANZALDUA CEO 843-732-9340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist Psychiatric/Mental Health, Adult |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult | |
| 363LA2200X Nurse Practitioner Adult Health | |
| Enumeration Date | 2021-11-20 |
| Last Update Date | 2021-11-20 |