| NPI | 1629337530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNELL ANTHONY Owner 803-397-8059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: SC 5347) |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2012-05-11 |