| NPI | 1770342040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHMEAKA ROCHELLE CAMPBELL Owner 843-530-1643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 311ZA0620X Custodial Care Facility Adult Care Home | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2024-03-18 |