| NPI | 1720652928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TRUESDALE Manager 803-320-2064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2021-05-13 |