| NPI | 1679066484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH JOLLY NEELY Owner/Lpc 864-266-4339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: SC 5651) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: SC 5651) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: SC 5651) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: SC 5651) | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-06-07 |