| NPI | 1720972219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHA M FREDERICK Owner 803-543-3660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2025-06-07 |
| Last Update Date | 2025-06-07 |