| NPI | 1700380904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH MCVEY Credentialing Specialist 803-605-4806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-03-21 |