| NPI | 1629467022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN COFFIN Executive Director 843-365-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: SC 57-0741188) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-01-22 |