| NPI | 1639587470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY INNISS CEO 843-501-0120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X | |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2014-07-24 |