| NPI | 1801537352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MARIA ROBERTSON Owner 864-590-1077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X | |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2023-07-21 |