| NPI | 1811715501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAILA LEIGH ASBURY Clinical Social Worker 843-405-3161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-10-01 |