| NPI | 1740157072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN JACKSON Administrator 864-419-0167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center Adult Day Care |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2025-10-21 |
| Last Update Date | 2025-10-21 |