| NPI | 1598044885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVA A CLARK Therapist 803-378-2895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SC 4958) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2011-08-04 |