| NPI | 1811220569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN EVERAROD MALONE Case Manager 803-609-4132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2009-10-14 |