| NPI | 1811327745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA NORDLUND Program Director, Owner 803-758-2445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SC OTP0094) |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2013-11-13 |