| NPI | 1700596269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIQUIA TYESHA SIMON Chief Executive Officer 843-616-4225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-11-24 |
| Last Update Date | 2022-11-24 |