| NPI | 1790021970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA ANN BLACK Program Manager 803-896-9029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: SC 006545) |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2012-12-17 |