| NPI | 1710063375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN J. SHORT Member 864-679-0023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: SC SR-0009711001-CCI) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2008-03-11 |