| NPI | 1649034547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANDA HIGGINS Practice Owner 843-509-6732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2024-02-12 |