| NPI | 1659699544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE JOHNSON Owner 803-755-0681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: SC 5155) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2010-05-17 |