| NPI | 1669822425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOB WAYNE WINKLER Counselor 803-270-0624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 008705) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2017-01-04 |