| NPI | 1760548184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA MOEN Chief Compliance Officer 843-687-4329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 0416AD076701) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2023-04-19 |