| NPI | 1639051949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKKI RACQUEL SMITH Nurse Practitioner 803-776-1053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-07-25 |
| Last Update Date | 2025-09-16 |