| NPI | 1790510709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA PURYEAR Owner 803-403-7891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2024-09-09 |