NPI | 1770093684 |
---|---|
Entity Type | Organization |
Authorized Contact | DOMINIC BRANDON SIMON CEO 803-225-6441 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: SC 462164732) |
Enumeration Date | 2017-10-05 |
Last Update Date | 2022-07-21 |