| NPI | 1659770857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENNIE S MULLIS Counselor 803-289-4298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SC 5741) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-08-14 |