| NPI | 1639851132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELENA NICOLE SHIVERS Owner 803-979-6171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2023-11-20 |